Spatial Distribution and Temporal Trends of Hospitalizations for Primary Care–Sensitive Conditions in Northeast Brazil: An Ecological Study, 2015–2024

Abstract

Objective: To  analyze  the  epidemiological  profile,  spatial  distribution,  and  temporal  trends  of Hospitalizations  for  Primary  Care  Sensitive  Conditions  (PCSC)  in  Northeastern Brazil  between 2015  and  2024. Methods: This  ecological,  descriptive  study  employed  spatial  and  temporal analyses using data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), available through DATASUS. The analyzed variables included year of diagnosis, state of  residence,  age  group,  sex,  and  race/skin  color.  Incidence  rates  were  estimated  per  100,000 inhabitants, and temporal trends were assessed using Joinpoint regression analysis. Results: There were  16,713,834  recorded hospitalizations.The  highest  incidence  rates  were  observed  for infectious  and  parasitic  diseases  (540.89  per  100,000  inhabitants),  followed  by  diseases  of  the digestive (529.39 per 100,000), respiratory (518.40 per 100,000), and circulatory systems (457.35 per 100,000). The highest incidence was identified among individuals aged 60–69 years (374.91 per 100,000 inhabitants), with predominance among females and self-reported mixed-race (Parda) individuals.  The  states  of  Rio  Grande  do  Norte,  Paraíba,  and  Sergipe  showed  statistically significant   increasing   trends   in   PCSC   incidence   rates   during   the   post-pandemic   period. Conclusion: PCSC  hospitalizations  remained  high  in  Northeastern  Brazil  throughout  the  study period,  with  differences  observed  across  populationgroups  and  states. These  findings  reinforce the importance of strengthening Primary Health Care and implementing public policies aimed at reducing regional inequalities and preventing avoidable hospitalizations.