Hospitalizations due to primary care-sensitive cardiovascular conditions in municipalities of Central-West Brazil.
OBJECTIVE
To analyze rates of hospitalization due to primary care-sensitive cardiovascular conditions.


METHODS
This ecological study on 237 municipalities in the state of Goiás, Central-West Brazil, between 2000 and 2008, used data from the Hospital Information System and the Primary Care Information System. The hospitalization rates were calculated as the ratio between the number of hospitalizations due to cardiovascular conditions and the population over the age of 40 years. The data were evaluated over the three-year periods A (2000-2002), B (2003-2005) and C (2006-2008), according to sex, age group, population size, whether the individual belonged to the metropolitan region, healthcare macroregion, distance from the state capital, living conditions index and coverage within the Family Health Strategy. The potential population coverage of the Family Health Strategy was calculated in accordance with Ministry of Health guidelines. The variability of the rates was evaluated using the t test and ANOVA.


RESULTS
A total of 253,254 hospitalizations (17.2%) occurred due to primary care-sensitive cardiovascular conditions. The hospitalization rates diminished between the three-year periods: A (213.5, SD = 104.6), B (199.7, SD = 96.3) and C (150.2, SD = 76.1), with differences from A to C and from B to C (p < 0.001). Municipal population size did not influence the behavior of the rates. Municipalities near the state capital and those in the metropolitan area presented higher rates (p < 0.001). At all percentiles of the Life and Health Conditions Index, there were decreases in the rates (p < 0.001), except at percentile 1. Decreases were also observed in all the macroregions except for the northeastern region of the state. The reduction in rates was independent of the Family Health Strategy coverage.


CONCLUSIONS
The rates of hospitalization due to primary care-sensitive cardiovascular conditions decreased in these municipalities, independent of the Family Health Strategy coverage.
Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brasil. sandrorbatista@gmail.com
Sandro Rogério Rodrigues
SR
Batista
Paulo César Brandão Veiga
PC
Jardim
Ana Luiza Lima
AL
Sousa
Cláudia Maria
CM
Salgado
D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002947:Cities / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012111:Residence Characteristics; D012189:Retrospective Studies; D017678:Sex Distribution