The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007

Bibliographic Details
Main Author: Macinko, James
Publication Date: 2011
Other Authors: Oliveira, Veneza Berenice de, Turci, Maria Aparecida, Guanais, Frederico C., Bonolo, Palmira de Fátima, Costa, Maria Fernanda Lima
Format: Article
Language: eng
Source: Repositório Institucional da FIOCRUZ (ARCA)
DOI: 10.2105/AJPH.2010.198887.
Download full: https://arca.fiocruz.br/handle/icict/8878
Summary: New York University. Department of Nutrition, Food Studies, and Public Health. New York, NY.
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spelling Macinko, JamesOliveira, Veneza Berenice deTurci, Maria AparecidaGuanais, Frederico C.Bonolo, Palmira de FátimaCosta, Maria Fernanda Lima2014-11-17T14:29:23Z2014-11-17T14:29:23Z2011MACINKO, James et al. The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007. American Journal of Public Health, 101(10): 1963-1970, 2011.0090-0036https://arca.fiocruz.br/handle/icict/887810.2105/AJPH.2010.198887.engAmerican Public Health AssociationThe influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleNew York University. Department of Nutrition, Food Studies, and Public Health. New York, NY.Universidade Federal de Minas Gerais. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brazil.Escola Nacional de Administração Pública. Brasılia, DF, Brazil.Universidade Federal de Ouro Preto. Departamento de Medicina. Ouro Preto, MG, Brazil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, BrasilObjectives. We assessed the influence of changes in primary care and hospital supply on rates of ambulatory care–sensitive (ACS) hospitalizations among adults in Brazil. Methods. We aggregated data on nearly 60 million public sector hospitalizations between 1999 and 2007 to Brazil's 558 microregions. We modeled adult ACS hospitalization rates as a function of area-level socioeconomic factors, health services supply, Family Health Program (FHP) availability, and health needs by using dynamic panel estimation techniques to control for endogenous explanatory variables. Results. The ACS hospitalization rates declined by more than 5% annually. When we controlled for other factors, FHP availability was associated with lower ACS hospitalization rates, whereas private or nonprofit hospital beds were associated with higher rates. Areas with highest predicted ACS hospitalization rates were those with the highest private or nonprofit hospital bed supply and with low (<25%) FHP coverage. The lowest predicted rates were seen for áreas with high (>75%) FHP coverage and very few private or nonprofit hospital beds. Conclusions. These results highlight the contribution of the FHP to improved health system performance and reflect the complexity of the health reform processes under way in Brazil.ACS hospitalizationPublic health03 Saúde e Bem-Estarinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-81914https://arca.fiocruz.br/bitstreams/8b1444f1-8161-4134-bd27-0f69ca3d611f/download7d48279ffeed55da8dfe2f8e81f3b81fMD51falseAnonymousREADORIGINALThe Influence of Primary Care and Hospital Supply on Ambulatory Care–Sensitive Hospitalizations Among Adults in Brazil, 1999–2007.pdfThe Influence of Primary Care and Hospital Supply on Ambulatory Care–Sensitive Hospitalizations Among Adults in Brazil, 1999–2007.pdfapplication/pdf533659https://arca.fiocruz.br/bitstreams/53516537-649e-43ad-be69-4022147a8f51/downloadbb1e5d883c73442339315e260da9997aMD52trueAnonymousREADTEXTThe Influence of Primary Care and Hospital Supply on Ambulatory Care–Sensitive Hospitalizations Among Adults in Brazil, 1999–2007.pdf.txtThe Influence of Primary Care and Hospital Supply on Ambulatory Care–Sensitive Hospitalizations Among Adults in Brazil, 1999–2007.pdf.txtExtracted texttext/plain47627https://arca.fiocruz.br/bitstreams/cab72929-c06b-41d5-8b2b-b4e87567b535/download12b7a7706976a8ceef332acad38680b0MD55falseAnonymousREADTHUMBNAILThe Influence of Primary Care and Hospital Supply on Ambulatory Care–Sensitive Hospitalizations Among Adults in Brazil, 1999–2007.pdf.jpgThe Influence of Primary Care and Hospital Supply on Ambulatory Care–Sensitive Hospitalizations Among Adults in Brazil, 1999–2007.pdf.jpgGenerated Thumbnailimage/jpeg6076https://arca.fiocruz.br/bitstreams/36807e02-672c-482b-b656-0edb6269b8f4/downloadadddaaedd6555f5d66535ca2c7728053MD56falseAnonymousREADicict/88782025-07-29 21:00:01.195open.accessoai:arca.fiocruz.br:icict/8878https://arca.fiocruz.brRepositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352025-07-30T00:00:01Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)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
dc.title.none.fl_str_mv The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
title The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
spellingShingle The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
Macinko, James
ACS hospitalization
Public health
03 Saúde e Bem-Estar
title_short The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
title_full The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
title_fullStr The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
title_full_unstemmed The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
title_sort The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007
author Macinko, James
author_facet Macinko, James
Oliveira, Veneza Berenice de
Turci, Maria Aparecida
Guanais, Frederico C.
Bonolo, Palmira de Fátima
Costa, Maria Fernanda Lima
author_role author
author2 Oliveira, Veneza Berenice de
Turci, Maria Aparecida
Guanais, Frederico C.
Bonolo, Palmira de Fátima
Costa, Maria Fernanda Lima
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Macinko, James
Oliveira, Veneza Berenice de
Turci, Maria Aparecida
Guanais, Frederico C.
Bonolo, Palmira de Fátima
Costa, Maria Fernanda Lima
dc.subject.en.none.fl_str_mv ACS hospitalization
Public health
topic ACS hospitalization
Public health
03 Saúde e Bem-Estar
dc.subject.ods.none.fl_str_mv 03 Saúde e Bem-Estar
description New York University. Department of Nutrition, Food Studies, and Public Health. New York, NY.
publishDate 2011
dc.date.issued.fl_str_mv 2011
dc.date.accessioned.fl_str_mv 2014-11-17T14:29:23Z
dc.date.available.fl_str_mv 2014-11-17T14:29:23Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv MACINKO, James et al. The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007. American Journal of Public Health, 101(10): 1963-1970, 2011.
dc.identifier.uri.fl_str_mv https://arca.fiocruz.br/handle/icict/8878
dc.identifier.issn.none.fl_str_mv 0090-0036
dc.identifier.doi.none.fl_str_mv 10.2105/AJPH.2010.198887.
identifier_str_mv MACINKO, James et al. The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007. American Journal of Public Health, 101(10): 1963-1970, 2011.
0090-0036
10.2105/AJPH.2010.198887.
url https://arca.fiocruz.br/handle/icict/8878
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dc.publisher.none.fl_str_mv American Public Health Association
publisher.none.fl_str_mv American Public Health Association
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