Hospitalisations due to ambulatory care sensitive conditions (ACSC) between 2009 and 2018 in Brazil’s Federal District as compared with other state capitals

Pinto, Luiz Felipe; Mendonça, Claunara Schilling; Rehem, Tania Cristina Morais Santa Barbara; Stelet, Bruno

doi:10.1590/1413-81232018246.08582019

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ARTICLE • Ciênc. saúde colet. 24 (6) • June 2019 • https://doi.org/10.1590/1413-81232018246.08582019 copy

Hospitalisations due to ambulatory care sensitive conditions (ACSC) between 2009 and 2018 in Brazil’s Federal District as compared with other state capitals

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study compared standardised rates of hospitalisations due to ambulatory care sensitive conditions (ACSCs) in Brazil’s Federal District from 2009 to 2018, as compared with those for selected state capitals, age groups and admissions groups. This ecological study used secondary data drawn from Hospital Information System microdata for the study period, during which, in the Federal District, the proportion of such admissions among 50-59 and 60-69 year olds declined, while those among children and adolescents held stable. Meanwhile, rates did not decrease in the ≤ 20 year age groups, a priority population in PHC, which may suggest that this population encountered barriers to access. The results showed that the expected reduction in the proportion of such admissions has not occurred, because coverage by Family Health Teams has been expanded only recently.

Keywords
Primary health care; Hospitalisations due to ambulatory care sensitive conditions

Years	0-9	10-19	20-29	30-39	40-49	50-59	60-69	70-79	80 or +	Total
2009	21.7%	9.8%	5.4%	6.8%	14.2%	21.5%	21.7%	12.8%	15.7%	12.7%
2010	22.2%	10.4%	5.0%	6.8%	14.4%	22.3%	22.8%	12.1%	13.4%	12.9%
2011	23.3%	10.5%	5.6%	7.8%	14.0%	22.6%	22.6%	11.1%	13.6%	13.3%
2012	26.2%	10.9%	5.5%	7.6%	14.7%	22.6%	23.0%	12.1%	14.3%	14.1%
2013	26.9%	10.3%	5.5%	6.9%	13.6%	22.5%	21.8%	13.1%	16.7%	13.9%
2014	23.9%	9.7%	5.3%	6.3%	12.9%	20.9%	20.7%	12.1%	15.5%	12.8%
2015	28.2%	10.9%	4.9%	5.9%	13.1%	20.9%	19.8%	11.9%	14.5%	13.4%
2016	24.3%	10.0%	4.8%	6.0%	12.7%	19.3%	17.5%	11.4%	14.0%	12.6%
2017	22.9%	11.4%	5.2%	6.2%	12.0%	18.1%	16.6%	10.9%	15.0%	12.7%
2018	22.6%	11.1%	5.5%	5.7%	11.1%	17.0%	16.3%	10.6%	15.6%	12.6%

HACSC groups	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
1	0.3	0.3	0.3	0.5	0.4	0.7	0.3	0.2	0.2	0.1
2	0.6	0.7	0.7	0.8	0.9	0.7	1.1	1.3	1.0	1.0
3	0.6	0.3	0.6	0.9	0.7	0.5	0.6	0.5	0.6	0.5
4	0.1	0.1	0.1	0.1	0.0	0.1	0.0	0.0	0.0	0.0
5	0.9	1.2	0.9	1.1	0.9	0.8	0.8	1.0	0.7	0.8
6	3.3	2.9	3.2	2.7	3.0	2.9	2.6	4.0	4.0	4.0
7	15.3	14.7	11.3	12.1	11.7	11.2	13.5	13.5	14.9	15.5
8	6.6	5.5	6.6	8.1	9.1	7.2	8.5	7.7	7.9	8.6
9	5.0	6.3	7.9	8.7	7.4	6.9	9.9	8.8	12.3	11.9
10	7.2	6.6	6.0	5.4	6.2	5.5	3.6	3.5	2.8	2.8
11	4.8	5.6	5.4	5.9	5.7	6.1	5.7	4.5	3.2	3.3
12	8.1	7.1	6.7	6.7	8.3	9.0	9.3	7.8	7.7	6.4
13	5.8	7.4	7.9	8.1	6.0	7.0	6.3	7.0	6.6	6.0
14	9.6	10.0	9.6	9.1	8.8	9.4	7.9	8.4	7.6	7.7
15	4.6	3.9	4.3	4.7	5.1	4.6	5.1	6.7	5.3	6.7
16	11.2	10.9	11.5	10.9	11.7	12.2	12.7	12.9	11.8	11.1
17	7.0	7.0	7.5	6.4	5.8	6.1	5.2	5.1	4.8	4.8
18	1.9	1.9	1.7	1.7	1.8	1.9	1.3	1.5	1.7	1.9
19	2.5	2.5	2.5	2.1	2.1	1.9	1.9	2.4	2.5	2.8
20	4.5	5.2	5.2	4.3	4.5	5.2	3.5	3.2	4.3	4.2
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0

	Distribution (%) of HACSCs in relation to total admissions

Year	BR TT	BR CAP	DF	SP (Mun)	RJ (Mun)	BH	POA	CUR	FL
2009	13.9	10.9	12.7	11.1	10.8	14.7	14.2	6.4	10.4
2010	13.7	10.8	12.9	11.0	11.8	14.2	15.1	6.3	9.8
2011	13.6	10.9	13.3	11.4	11.0	12.7	15.9	6.7	9.3
2012	13.3	11.0	14.1	11.2	10.4	13.2	16.0	7.3	8.2
2013	13.1	10.8	13.9	11.1	9.6	12.6	15.2	7.6	8.8
2014	12.8	10.7	12.8	10.9	8.7	11.9	15.0	7.8	9.8
2015	12.6	10.8	13.4	10.9	9.2	12.1	15.7	7.9	9.9
2016	12.2	10.7	12.6	10.8	8.8	12.3	15.6	7.9	10.4
2017	12.1	10.7	12.7	10.6	8.6	12.7	14.9	8.0	10.3
2018	12.2	10.8	12.6	10.7	9.5	12.9	14.5	8.5	11.1

	Distribution of standardised HACSC rates per 10,000 population

Year	BR TT	BR CAP	DF	SP (Mun)	RJ (Mun)	BH	POA	CUR	FL
2009	84.3	58.7	81.1	57.4	36.0	76.7	96.2	39.1	51.6
2010	84.2	60.4	83.8	59.6	39.8	81.7	105.0	39.9	46.0
2011	82.0	60.5	84.2	61.2	38.1	70.6	104.7	41.7	45.7
2012	78.2	59.4	86.0	58.3	35.0	72.9	112.4	43.6	38.4
2013	73.8	57.5	78.3	56.1	33.3	69.5	104.8	42.1	39.4
2014	71.5	54.8	66.4	54.7	29.5	67.7	104.9	42.1	48.0
2015	69.9	56.2	67.9	53.9	34.7	66.7	112.4	43.9	49.9
2016	66.0	55.2	68.2	55.2	29.6	68.5	108.8	44.9	53.6
2017	62.8	54.6	66.5	54.0	29.3	68.9	102.7	47.9	50.7
2018	61.9	54.2	68.8	51.0	31.2	71.6	90.3	51.0	57.5

	Distribution of standardised Non-HACSC rates per 10,000 population

Year	BR TT	BR CAP	DF	SP (Mun)	RJ (Mun)	BH	POA	CUR	FL

2009	521.3	477.2	533.0	461.3	300.3	436.3	564.4	574.9	434.4
2010	530.4	486.9	538.9	479.3	292.2	456.8	559.1	602.2	408.7
2011	523.1	483.8	526.0	473.5	304.7	451.5	521.4	588.6	428.6
2012	511.2	471.1	500.3	462.7	296.8	441.4	553.0	560.8	408.4
2013	497.9	461.8	460.7	447.0	309.6	448.1	548.4	518.5	387.8
2014	497.1	449.1	429.1	442.9	304.0	468.1	553.4	504.9	422.0
2015	492.5	453.8	417.7	436.0	339.8	455.4	559.5	515.4	431.8
2016	483.4	451.8	455.1	451.3	302.1	465.1	543.8	524.6	442.1
2017	464.2	445.3	440.9	444.5	307.5	446.5	539.4	553.4	416.6
2018	456.7	433.1	460.0	414.9	294.4	462.6	486.0	545.0	432.4

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[1] Collaborations

LF Pinto contributed to the design, design, writing, analysis and review of data. CS Mendonça conducted the critical review of the article. TCMSB Rehem contributed in the Introduction and B Stelet in the analysis of the data.