Primary care-sensitive hospitalization conditions in children under the age of 1 in Brazil

Pinto Junior, Elzo Pereira; Aquino, Rosana; Dourado, Inês; Costa, Líllian de Queiroz; Silva, Marcelo Gurgel Carlos da

doi:10.1590/1413-81232020257.25002018

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FREE THEMES • Ciênc. saúde coletiva 25 (7) • July 2020 • https://doi.org/10.1590/1413-81232020257.25002018 copy

Primary care-sensitive hospitalization conditions in children under the age of 1 in Brazil

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Abstract

Primary care-sensitive condition hospitalizations (PCSCH) are an essential health care indicator. This ecological, time-series study aimed to analyze the time trend of PCSCH in children under the age of 1 in Brazil, considering the age subcomponents of newborns and post-newborns. The PCSCH rates were calculated for infants under the age of 1 and in the neonatal and postneonatal subgroups. The Prais-Winsten generalized linear analysis model and the Annual Percent Change (APC) calculation were used to evaluate the time trend. The results showed that infectious gastroenteritis represented the most important cause of hospitalizations due PCSCH in children under the age of 1. Congenital syphilis and other congenital infections accounted for the highest proportion of hospitalizations in newborns, whereas gastroenteritis prevailed in post-newborns. An increase in newborn hospitalization rates and a decrease in hospitalization rates in both the postneonatal group and the group of children under the age of 1. Differences in trends in these hospitalization rates may reflect the influence of specific determinants on the risk of hospitalization in each age subcomponent.

Key words
Primary Health Care; Child Health; Hospitalization; Time-Series Studies; Ecological Studies

Age group	Groups of causes	Total hospitalizations	Proportion of hospitalizations
Newborn (0-27 days)	1º Congenital syphilis and other congenital infections	80,488	29.5%
Newborn (0-27 days)	2º Infectious gastroenteritis	52,300	19.2%
	3º Bacterial pneumonia	31,432	11.5%
	4º Lung diseases	29,930	11.0%
	5º Kidney and urinary tract infection	17,868	6.6%
	All PCSCHs	272,443	-
Post-newborn	1º Infectious gastroenteritis	1,176,965	41.1%
(28-364 days)	2º Bacterial pneumonia	479,596	16.7%
	3º Lung diseases	467,336	16.3%
	4º Asthma	361,962	12.6%
	5º Kidney and urinary tract infection	114,875	4.0%
	All PCSCHs	2,866,097	-
< 1 year	1º Infectious gastroenteritis	1,229,265	39.2%
	2º Bacterial pneumonia	510,938	16.3%
	3º Lung diseases	497,266	15.8%
	4º Asthma	373,576	11.9%
	5º Kidney and urinary tract infection	132,743	4.2%
	All PCSCHs	3,138,540	-

Year	Congenital syphilis and other congenital infections	Lung diseases	Gastroenteritis	Kidney and urinary tract infection	Bacterial pneumonia
2000	0.78	0.43	1.46	0.18	0.30
2001	1.23	0.45	1.58	0.21	0.24
2002	1.14	0.45	1.69	0.27	0.76
2003	1.45	0.46	1.55	0.28	1.00
2004	1.46	0.53	1.32	0.26	1.00
2005	1.48	0.50	1.28	0.30	0.91
2006	1.52	0.51	1.17	0.30	0.91
2007	1.42	0.60	1.03	0.35	0.89
2008	1.30	0.74	1.21	0.49	0.76
2009	1.26	0.70	0.96	0.54	0.76
2010	1.44	0.67	0.92	0.51	0.63
2011	1.66	0.80	0.77	0.48	0.55
2012	1.96	0.79	0.76	0.48	0.47
2013	2.47	0.85	0.71	0.47	0.55
2014	3.03	0.75	0.57	0.47	0.41
2015	3.69	0.91	0.49	0.48	0.42
APC (95%CI)	24.0% (11.0 - 38.5)	12.6% (10.1 - 15.1)	*-16.0% (-18.8 - -13.0)	16.5% (7.9 - 25.7)	*1.9% (-16.7 - 24.7)
Trend	Increase	Increase	Decrease	Increase	Stable

Year	Gastroenteritis	Bacterial pneumonia	Lung diseases	Asthma	Kidney and urinary tract infection
2000	40.11	3.54	7.47	10.18	1.30
2001	40.40	3.04	7.65	9.93	1.52
2002	39.94	13.85	7.02	11.42	1.76
2003	37.59	17.53	7.09	11.37	1.88
2004	34.02	16.24	7.72	10.64	1.89
2005	32.89	14.04	7.59	9.09	2.15
2006	30.76	14.94	8.42	8.98	2.19
2007	21.63	14.43	9.57	9.22	2.29
2008	20.63	9.45	9.64	6.62	2.30
2009	19.18	10.45	10.84	6.64	2.99
2010	18.78	8.85	10.89	5.83	2.96
2011	13.23	7.82	12.63	5.26	2.87
2012	12.99	7.00	13.05	4.67	3.09
2013	10.46	7.26	13.52	4.22	3.15
2014	10.14	6.49	12.03	3.40	3.22
2015	8.37	6.67	13.07	3.33	3.40
APC (95%CI)	-22.6% (-25.6 - -19.5)	3.6% (-17.9 - 30.6)	10.9% (7.5 - 14.4)	-17.0% (-21.6 - -12.1)	14.9% (12.1 - 17.8)
Trend	Decrease	Stable	Increase	Decrease	Increase

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[1] Collaborations

EP Pinto Junior participated in the conception and design, analysis and interpretation of data, and drafting of the paper. R Aquino participated in the conception and design, data interpretation, and relevant critical review of the paper’s intellectual content. I Dourado participated in data interpretation and relevant critical review of the intellectual content of the paper. LQ Costa participated in the conception and project, data interpretation, and drafting of the paper. MGC Silva participated in the conception and design, data interpretation, and relevant critical review of the paper’s intellectual content.