Internações por condições sensíveis à atenção primária no Brasil: análise hierarquizada de fatores de contexto, estrutura e processo de trabalho

• Ano de defesa: 2015
• Autor(a) principal: Araújo, Waleska Regina Machado
• Orientador(a): THOMAZ, Erika Bárbara Abreu Fonseca
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Maranhão
• Programa de Pós-Graduação: PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBS
• Departamento: SAÚDE PÚBLICA
• País: BR
• Palavras-chave em Português: Hospitalização; Atenção Primária à Saúde; Avaliação em Saúde; Avaliação de Processos (Cuidados de Saúde); Avaliação de Resultados (Cuidados de Saúde)
• Palavras-chave em Inglês: Hospitalization; Primary Health Care; Outcome and Process Assessment (Health Care)
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
• Link de acesso: http://tedebc.ufma.br:8080/jspui/handle/tede/1006

Introduction: activities of primary health care as the prevention, diagnosis and treatment of diseases and the control and monitoring of chronic diseases, can determine a reduction in Hospital Admissions for Sensitive Conditions Primary Health (ICSAP). These conditions include a list of health issues for which hospitalization can be prevented with an effective intervention of primary care through the timely control of acute illnesses and management of chronic diseases and their complications. Objective: Investigate if characteristics of the structure of the Basic Health Units (UBS) and the work process of Primary Care Teams (EAB) are associated with the number of hospitalizations for Sensitive Conditions Primary (ICSAP). Methods: This is an ecological study. Data were derived from sociodemographic characteristics, coverage of assistance programs, structure of the Basic Health Units (UBS) and wor teams process of Brazilian municipalities. Data were collected from secondary data from the Brazilian Institute of Geography and Statistics, the United Nations Development Programme, the Department of the Unified Health System and the first cycle of Access Improvement Programme and Quality of Primary Care (PMAQ-AB). We considered the number of ICSAP in the years 2013 and 2014 were estimated associations through negative binomial regression coefficients and confidence intervals at 95%, with hierarchical approach in three blocks (alpha = 5%). Results: After adjustment for 2013 in the distal block, the coverage of the Bolsa Família Program (β = -0.001) and private plan (β = -0.01) showed a negative association and the human development index (β = 1, 13), the proportion of elderly (β = 0.05) and less than five years (β = 0.05) and the cover of the Community Agents Health Strategy (β = 0.002) showed a positive association. The intermediate block, showed negative association the minimum time (β = -0.14) and the availability of vaccine (β = -0.16) and positive association, the availability of drugs (β = 0.16). The proximal block, only the variable matrix support (β = 0.10) showed a positive association. In analysis adjusted 2014, the variables had the same sense of association 2013. Conclusions: The increased coverage of income distribution programs, UBS largest percentage of working in minimum time and the greater availability of vaccines are significantly associated with reduce ICSAP.