Internações por condições sensíveis à atenção ambulatorial : uma ferramenta para avaliação da estratégia saúde da família

Abstract

PROPOSITION: the need to utilize evaluated methods to check primary care effective actions. OBJECTIVE: This study evaluated the FHS assistance comparing with traditional Health Centers, taking as marker the hospitalization due Ambulatory Care Sensitive Conditions (ACSC) and to evaluate the prevalence and the factors associates with pediatric hospitalization due ambulatory care sensitive conditions. METHODS: a hospital survey was carried out with a sample of patients in surgery, pediatric and internal medicine patients rooms of hospitals contracted by Brazilian Health Care System in Montes Claros, Minas Gerais. Interviews had been carried out with patients and from July 2007 to July 2008, including medical records review. RESULTS: 660 patients in surgery and internal medicine patients rooms had been interviewed. The percentage of ACSC among all the hospitalizations was 38.8% (n=256). The variables statistically associated with the ACSC in this study were: previous hospitalization (OR=1.62; 95%CI=1.51-2.28), regular visits to a health center (OR=2.20; 95%CI=1.44-3.36), low educational level (OR=1.50; 95%CI =1.02- 2.20), health control assistance not realized by the FHS team (OR=2.48; 95%CI=1.64-3.74), hospitalization request by doctors who do not act in FHS (OR=2.25; 95%CI=1.03-4.94) and age equal to or above 60 (OR=2,12; IC95%=1,45-3,09). It had been interviewed 365 families of hospitalized children and the prevalence of hospitalization due ambulatory care sensitive conditions were of 41.4% (n=151). The logistic regression analysis showed that, in a joint analysis, the variables statistically associated with hospitalization due ambulatory care sensitive conditions were: to inhabit in area attended by the Strategy of Health of Family (OR=1.65; 95%CI=1.04-2.60) and children under two years of age (OR=2.39; 95%CI=1.54-3.71). CONCLUSIONS: to the adults and elderlies, the results showed better performance of the Family Health Strategy Teams to control the ACSC. To the children, the variables can indicate social vulnerability. The lack of national studies affect further detailed analyses of the results.