Internações por condições sensíveis à atenção primária em Minas Gerais, entre 1999 e 2007

Abstract

The Family Health Strategy (FHS) showed a rapid expansion since its inception and has established itself as the main form of implementation of Primary Health Care (PHC) in Brazil. This fact highlights the need for regular monitoring and evaluation, so that there is an effective and quality service. The Hospitalization by Primary Care Sensitive Conditions (HPCSC) emerged as a new indicator in the country, from 2008 in order to assess the effectiveness of primary health care. This research analyzes the HPCSC rates in Minas Gerais, between 1999 and 2007. This is an ecological and analytic study of HPCSC for Minas Gerais and their health macro-regions, which included the analysis of correlation between HPCSC rates and coverage rates of the Family Health Strategy. Secondary data from the Information System of the Ministry of Health and population estimate from the Brazilian Institute of Geography and Statistics were used. We evaluated the population 20-79 years and were excluded hospitalizations for deliveries. The HPCSC rates followed a downward trend between 1999 and 2007. During the study period the rate increased from 244.19 to 143.5 / 10,000, representing a decrease of 41.2% or an average annual decrease of 5.15% per year. Among the HPCSC, asthma, heart failure, cerebrovascular disease, infectious gastroenteritis and its complications, infections of the kidneys and urinary tract and bacterial pneumonia were the most prevalent. These conditions accounted for over 50% of all HPCSC in 1999 and subsequent years until 2007. There was a reduction in all macro health regions, but unevenly. The largest percentage decreases occurred for the Northwest region (-67.8%), West (-64.9%) and South Triangle (-61.8%). Smaller reductions were recorded in the Northeast macro-regions (-34.0%), Southeast (-41.5) and Jequitinhonha (-45.1%). Registered even negative and statistically significant correlation between population coverage by the Family Health Strategy and the total HPCSC for the period studied. It is concluded that the decreased rate ICSAP over the years, associated with the increase of population coverage by the FHT.