Atendimentos pediátricos por condições sensíveis à atenção primária em serviços de urgência e emergência hospitalar

Abstract

The primary health care (PHC) is the assistance model responsible for the reorganization of the whole health system. Its efficiency can be indirectly assessed on the other levels of health care through the Ambulatory Care Sensitive Conditions (ACSC), a list of diseases that should be remedied in its scope. This study evaluated the PHC through the pediatric consultations by ACSC in hospital emergencies services. This is a cross-sectional, documentary, quantitative and analytic study performed in a medium-sized city in the north of Minas Gerais. 723 records of pediatric consultations in the emergency services comprised in a period from 2010 to 2014 were analyzed and randomly chosen through the Poisson regression. The results showed that 31.8% of the pediatric consultations in the emergency services were for ACSC, prevailing consultations with children aged from 2 to 6 years old (36.8%) and male (54.3%). Among the children who were assisted that were diagnosed with the ACSC disease’s list, 82.5% were classified in lesser priority and 84.8% returned to the emergency units after the first consultation. Among the pediatrics hospitalizations occurred in this period, 37.8% occurred due to ACSC. The variables associated to ACSC were: children living in areas not covered by the Family Health Strategy (FHS), children living in areas covered by the FHS without multiprofessional residency, classification by consultation of lower priority in the emergency services and return to the hospital emergency services after the first consultation. The results denote that the expansion of the FHS’s coverage and the implementation of human resource training programs as the Family Health multiprofessional residency may decrease the hospitalizations and the pediatric consultations by ACSC in emergency services, indicating a more efficient PHC. It is possible to conclude that the ACSC list can be utilized as an important signaling to the principle’s evaluations in the FHSs. The extension of the FHS can reduce the pediatric internalization by ACSC and the occurrence of pediatric consultations by ACSC in emergency services, potentiated through the multiprofessional residency in Family Health in its units. Challenges point to an improvement of the longitudinality and access of pediatric care in PHC.