Trends in hospitalization due to cardiovascular conditions sensitive to
               primary health care

Lentsck, Maicon Henrique; Latorre, Maria do Rosário Dias de Oliveira; Mathias, Thais Aidar de Freitas

doi:10.1590/1980-5497201500020007

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Revista Brasileira de Epidemiologia

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Original Articles • Rev. bras. epidemiol. 18 (2) • Apr-Jun 2015 • https://doi.org/10.1590/1980-5497201500020007 copy

Trends in hospitalization due to cardiovascular conditions sensitive to primary health care

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To analyze the trend in hospitalizations for primary care-sensitive cardiovascular conditions for residents of the state of Paraná, Brazil, from 2000 to 2011.

METHODS:

Ecological, time series study of the rates of hospitalization for cardiovascular diseases in residents aged 35-74 years old by sex, age and main diagnosis for hospitalization. Data from the Hospital Information System of the Unified Health System (SIH-SUS) and polynomial regression models for trend analyses were used.

RESULTS:

Hospitalization rates for cardiovascular conditions decreased during the period (r²= 0.96; p < 0.001), with similar decreasing patterns for males and females, in all age ranges, although always higher for males. Although hospitalization trends for hypertension, heart failure and cerebrovascular disease decreased, angina remained stable for males and females.

CONCLUSION:

A downward trend in hospital admissions due to primary care-sensitive cardiovascular conditions in the state of Paraná between 2000 and 2011 may have resulted from the expansion of the health network of and the access to primary health attention, as well as other factors that influence this set of diseases, such as improved socioeconomic conditions of the population, organization of primary care services for higher age ranges and women and decrease in risk factors.

Cardiovascular diseases; hospitalization; Trends; Time series studies; Primary health care; Quality of health care

Causes	2000/ 2002	2003/ 2005	2006/ 2008	2009/ 2011	Model	r²	p-value	Trend
All	917.4	872.8	807.2	811.2	y = 856.95 – 15.33x	0.90	< 0.001	Decreasing
PCSC	332.5	298.0	238.8	209.1	y = 276.79 – 15.50x	0.98	< 0.001	Decreasing
PCSCC	143.0	131.8	103.8	92.8	y = 120.97 – 6.76x	0.96	< 0.001	Decreasing
Hypertension	20.4	18.4	14.8	9.3	y = 16.70 – 1.29x	0.92	<0.001	Decreasing
Angina	15.0	28.1	24.5	26.6	y = 23.84 + 0.62x	0.24	0.148	Stable
CHF	76.3	60.9	44.3	37.3	y = 56.42 – 4.73x	0.97	< 0.001	Decreasing
Cerebrovascular	31.6	24.4	20.2	19.6	y = 24.02 – 1.37x	0.89	< 0.001	Decreasing

	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011
Hypertension
Male	14.53	17.22	15.26	14.97	15.31	15.31	15.59	13.21	9.41	9.00	7.74	6.51
Female	22.82	27.50	24.25	21.86	21.30	21.27	20.33	17.09	12.94	12.29	10.73	9.17
35 – 44 years	6.65	7.55	6.54	5.95	5.97	5.77	5.71	5.03	3.96	4.04	3.29	2.92
45 – 54 years	18.01	20.95	18.07	16.49	16.72	15.80	15.33	12.07	9.19	8.45	7.52	6.29
55 – 64 years	30.27	37.01	32.23	30.06	29.27	30.51	29.37	24.57	16.93	16.28	13.75	11.01
65 – 74 years	47.44	58.84	54.50	52.15	51.80	53.12	53.42	42.50	30.81	28.39	24.88	22.13
Angina
Male	13.60	14.06	22.13	35.19	33.59	29.28	32.15	29.22	27.00	30.80	30.29	34.85
Female	10.79	12.20	17.16	25.30	24.59	20.64	22.78	18.96	17.71	19.82	20.55	24.37
35 – 44 years	2.72	3.06	3.61	6.08	5.65	4.51	5.23	4.72	3.93	5.10	5.24	6.00
45 – 54 years	11.04	11.82	16.90	26.74	27.26	22.83	24.07	20.66	17.70	20.31	20.23	23.49
55 – 64 years	23.55	24.79	37.68	57.83	55.02	47.76	53.77	43.63	42.41	45.59	44.14	52.44
65 – 74 years	31.50	34.87	56.68	83.62	78.48	71.49	76.38	64.21	59.06	66.08	67.40	77.40
CHF
Male	80.65	73.65	73.32	70.43	60.69	54.10	51.37	45.20	38.80	38.95	37.95	36.55
Female	83.36	75.12	71.69	69.92	58.33	52.25	49.69	43.01	37.62	38.34	37.77	34.22
35 – 44 years	14.34	13.48	12.87	12.28	9.81	8.58	8.31	7.12	6.63	6.03	5.97	5.79
45 – 54 years	50.52	45.36	43.43	43.13	35.14	32.46	31.87	25.69	21.91	20.38	19.53	18.47
55 – 64 years	142.27	127.39	123.69	118.53	100.79	91.34	87.93	71.40	59.76	59.65	58.67	54.97
65 – 74 anos	317.44	290.96	287.67	279.06	242.55	213.78	198.49	172.41	147.62	154.63	148.33	136.94
Cerebrovascular
Male	40.25	37.75	30.17	31.16	27.51	25.59	25.11	23.34	20.44	21.29	23.01	22.89
Female	29.36	29.50	23.52	23.18	20.25	19.26	20.00	17.76	15.23	16.61	17.62	16.91
35 – 44 years	6.94	6.50	4.93	4.85	4.37	4.15	4.30	4.19	4.29	4.43	4.66	4.08
45 – 54 years	22.53	22.48	17.74	17.54	15.92	13.95	14.07	12.13	10.64	11.43	11.87	12.41
55 – 64 years	60.22	57.42	45.53	45.07	39.78	38.26	38.87	32.72	27.65	29.22	31.24	29.56
65 – 74 years	127.32	123.94	101.18	105.76	91.14	87.04	86.79	77.03	63.49	66.59	70.97	70.72

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[1] Corresponding author: Maicon Henrique Lentsck. Rua Conde D'eu, 531, Vila Carli, CEP: 85040-290, Guarapuava, PR, Brasil. Email: maiconlentsck@yahoo.com.br.