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Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon

BACKGROUND: The Family Health Strategy (FHS) became consolidated as a primary care model and gatekeeper for the Unified Health System (Sistema Único de Saúde, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expansion allowed the SUS t...

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Autores principales: Campelo Barroso Carneiro, Vânia Cristina, Ribeiro de Oliveira, Paulo de Tarso, Rassy Carneiro, Saul, Cardoso Maciel, Marinalva, da Silva Pedroso, Janari
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8031449/
https://www.ncbi.nlm.nih.gov/pubmed/33831030
http://dx.doi.org/10.1371/journal.pone.0248823
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author Campelo Barroso Carneiro, Vânia Cristina
Ribeiro de Oliveira, Paulo de Tarso
Rassy Carneiro, Saul
Cardoso Maciel, Marinalva
da Silva Pedroso, Janari
author_facet Campelo Barroso Carneiro, Vânia Cristina
Ribeiro de Oliveira, Paulo de Tarso
Rassy Carneiro, Saul
Cardoso Maciel, Marinalva
da Silva Pedroso, Janari
author_sort Campelo Barroso Carneiro, Vânia Cristina
collection PubMed
description BACKGROUND: The Family Health Strategy (FHS) became consolidated as a primary care model and gatekeeper for the Unified Health System (Sistema Único de Saúde, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expansion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities. METHODS: In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the association between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Pará, in the Brazilian Amazon, from 2008 to 2017. RESULTS: The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory. CONCLUSIONS: The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.
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spelling pubmed-80314492021-04-14 Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon Campelo Barroso Carneiro, Vânia Cristina Ribeiro de Oliveira, Paulo de Tarso Rassy Carneiro, Saul Cardoso Maciel, Marinalva da Silva Pedroso, Janari PLoS One Research Article BACKGROUND: The Family Health Strategy (FHS) became consolidated as a primary care model and gatekeeper for the Unified Health System (Sistema Único de Saúde, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expansion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities. METHODS: In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the association between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Pará, in the Brazilian Amazon, from 2008 to 2017. RESULTS: The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory. CONCLUSIONS: The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon. Public Library of Science 2021-04-08 /pmc/articles/PMC8031449/ /pubmed/33831030 http://dx.doi.org/10.1371/journal.pone.0248823 Text en © 2021 Campelo Barroso Carneiro et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Campelo Barroso Carneiro, Vânia Cristina
Ribeiro de Oliveira, Paulo de Tarso
Rassy Carneiro, Saul
Cardoso Maciel, Marinalva
da Silva Pedroso, Janari
Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_full Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_fullStr Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_full_unstemmed Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_short Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_sort evidence of the effect of primary care expansion on hospitalizations: panel analysis of 143 municipalities in the brazilian amazon
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8031449/
https://www.ncbi.nlm.nih.gov/pubmed/33831030
http://dx.doi.org/10.1371/journal.pone.0248823
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