THE EFFECT OF PRIMARY CARE POLICY CHANGES ON HOSPITALIZATION FOR AMBULATORY CARE SENSITIVE CONDITIONS: NOTES FROM BRAZIL

Resumo

Objective: to assess the effect of changes on Primary Care policies on the trend in hospitalization rates for Ambulatory Conditions Sensitive to Primary Care in the city of Rio de Janeiro, Brazil. Study design: It´s an ecological study with data from Brazilian National Health Information System.  Methods: We performed interrupted time series analysis, comparing 3 different periods due to primary care policies in Brazil: 2008-2009; 2010-2017, and 2018-2019. Dataset included total ACSC and rates for 19 groups of conditions. Results: There was a non-significant increasing trend in baseline admissions. The reform impacted (policy #1) the change in trend, causing it to reduce in the period significantly. However, the change in the PNAB (policy #2) did not change the trend but reduced the rate of decline. Trends and differences among periods vary due to the ACSC group. Conclusion: Primary care is sensitive to changes in public health policies. The hospitalization rate for ambulatory care-sensitive conditions is an indicator that reflects the changes and the adaptability of the organization of the health service network to guarantee universal coverage and to attend to the population's demand.