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Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon

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  • Vânia Cristina Campelo Barroso Carneiro
  • Paulo de Tarso Ribeiro de Oliveira
  • Saul Rassy Carneiro
  • Marinalva Cardoso Maciel
  • Janari da Silva Pedroso

Abstract

Background: The Family Health Strategy (FHS) became consolidated as a primary care model and gatekeeper for the Unified Health System (Sistema Único de Saúde, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expansion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities. Methods: In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the association between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Pará, in the Brazilian Amazon, from 2008 to 2017. Results: The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory. Conclusions: The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.

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  • Vânia Cristina Campelo Barroso Carneiro & Paulo de Tarso Ribeiro de Oliveira & Saul Rassy Carneiro & Marinalva Cardoso Maciel & Janari da Silva Pedroso, 2021. "Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-14, April.
    • Handle: RePEc:plo:pone00:0248823
    DOI: 10.1371/journal.pone.0248823
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    References listed on IDEAS

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    1. Monica Viegas Andrade & Augusto Quaresma Coelho & Mauro Xavier Neto & Lucas Resende de Carvalho & Rifat Atun & Marcia C Castro, 2018. "Transition to universal primary health care coverage in Brazil: Analysis of uptake and expansion patterns of Brazil’s Family Health Strategy (1998-2012)," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-11, August.
    2. Romero Rocha & Rodrigo R. Soares, 2010. "Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 126-158, September.
    3. Macinko, J. & De Oliveira, V.B. & Turci, M.A. & Guanais, F.C. & Bonolo, P.F. & Lima-Costa, M.F., 2011. "The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007," American Journal of Public Health, American Public Health Association, vol. 101(10), pages 1963-1970.
    4. Denise de Fátima Barros Cavalcante & Valéria Silva Cândido Brizon & Livia Fernandes Probst & Marcelo de Castro Meneghim & Antonio Carlos Pereira & Gláucia Maria Bovi Ambrosano, 2018. "Did the Family Health Strategy have an impact on indicators of hospitalizations for stroke and heart failure? Longitudinal study in Brazil: 1998-2013," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-10, June.
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