Primary health care strategy and its impact on avoidable hospitalizations for ambulatory care-sensitive conditions, Paraguay, 2000-2017Estratégia de atenção primária à saúde e seu impacto nas internações hospitalares evitáveis por causas sensíveis à atenção ambulatorial, Paraguai, 2000-2017

Explore the effect of the implementation and strengthening of the primary care strategy (PHC) on hospitalizations for ambulatory care-sensitive conditions (HACSC). Descriptive cross-sectional observational study that considered the data from public hospital admissions records for the entire country for the period 2000-2017. The starting point of the PHC strategy is considered to be 2009. The diagnoses proposed by the Pan American Health Organization/World Health Organization were used in defining the HACSC diagnoses. The analysis of HACSC behavior considered two stages: 2000-2008 and 2009-2017. HACSC trended downward, with a difference of 6.75% between the final years of each stage. The greater the PHC coverage, the larger the reduction. The leading causes of HACSC were pneumonia and acute diarrheal disease. Admissions for chronic diseases largely fell, while admissions for infectious diseases rose. The degree of population coverage and access to family health units can limit the impact of PHC on HACSC. A reduction in HACSC was confirmed after PHC implementation in Paraguay. The results for admissions for chronic diseases are better than those for infectious diseases.