Intra-urban differences in rates of admissions for ambulatory care sensitive conditions in Brazil's Center-West region

Admissions for ambulatory care sensitive conditions (ACSCs) represent a useful indicator of assess to and the effectiveness of primary health care. This article examined rates of admissions for ACSCs and the main causes of admissions in intra-urban areas of the municipality of Goiânia, capital of the State of Goiás. An ecological study was conducted to determine rates of admissions in Goiânia's seven health districts between 2008 and 2013 using data from Hospital Admission Authorization forms obtained from the municipality's Hospital Information System. Admissions were georeferenced throughout the seven health districts. Age-adjusted rates of admissions for ACSCs were calculated and the most common causes of admissions were identified for each age group. A 95% confidence interval was calculated as a measure of precision of the rates. The average overall rate of admissions for ACSCs was 155.5 per 10,000 population. Rates were highest in the Southern District and lowest in the Southwest District. Rates were highest in the youngest and oldest age groups. The Northwest District showed the highest rates in nine groups of causes, notably chronic non-communicable diseases among adults. Our findings showed that there are major differences in rates across health districts, pointing to shortfalls in primary health coverage, quality problems and an inadequate care model in districts with high coverage.