Contribution of hospitalizations for primary care-sensitive conditions to the profile of admissions in the public health care system/Contribuicao das internacoes por condicoes sensiveis a atencao primaria no perfil das admissoes pelo sistema publico de saude

Objective. To describe the epidemiological profile of hospitalizations in the city of Divinopolis, state of Minas Gerais, Brazil, to estimate the prevalence of hospitalizations for primary care-sensitive conditions (HPCSC), and to evaluate the factors associated with the occurrence of HPCSC. Methods. A cross-sectional study was conducted of the two public health care institutions in Divinopolis qualified to hospitalize individuals; that is, a general hospital and an urgent care unit. The data were collected between July and October 2011. Admissions were screened based on information available through the state of Minas Gerais data exchange software SUS Facil, hospital admission authorizations, and patient records. Descriptive analyses were carried out, with estimation of the prevalence of admissions according to the groups of the 10th revision of the International Classification of Diseases (ICD-10). The identification and classification of HPCSC was based on the Brazilian List of primary-care sensitive conditions published by the Ministry of Health. The strength of the association between HPCSC and selected variables was estimated based on the prevalence ratio. Results. Two thousand seven hundred seventy five admissions were identified. The main causes were neoplasms (18%), diseases of the circulatory system (16%), pregnancy and childbirth (15%), and external causes (12%). The prevalence of HPCSC was 36.6%, with the main diagnoses being diseases of the circulatory and respiratory systems. One third of the admissions occurred through the urgent care unit, which was also responsible for more than half of the HPCSC. Female sex, age younger than 13 years and older than 40 years, and living in Divinopolis were associated with higher chance of admission due to HPCSC (P < 0.01). Conclusions. The results show a high prevalence of HPCSC, especially through the urgent care unit. This indicates an overburdening of urgent care services, hindering the implementation of a longitudinal continuum of care at the primary level. Key words Primary health care; hospitalization; health system; Brazil. Objetivo. Descrever o perfil epidemiologico das internacoes ocorridas na Cidade de Divinopolis (MG), Brasil, estimar a prevalencia de internacoes por condicoes sensiveis a atencao primaria (ICSAP) e avaliar os fatores associados com a ocorrencia de ICSAP. Metodos. Foi conduzido um estudo de transversal nos dois serviqos publicos de internacao do municipio: um hospital geral e uma