title: Reduction of ambulatory care sensitive conditions in Brazil between 1998 and 2009.
abstract: OBJECTIVE
  To describe the trends in hospitalizations for ambulatory care sensitive conditions between 1998 and 2009 in Brazil.
  
  
  METHODS
  The ecological time series study used secondary data on hospitalizations for ACSC in the Sistema Único de Saúde (SUS, National Unified Health System). Data were obtained from the Hospital Information System. Hospital admission rates per 10,000 inhabitants were standardized by age range and gender, using the 2000 census male Brazilian population as standard. Trend analysis of the historic series was performed through generalized linear regression using the Prais-Winsten method.
  
  
  RESULTS
  Between 1998 and 2009, there was an average annual reduction in admissions for ambulatory care sensitive conditions of 3.7% in men (95%CI -2.3;-5.1) and women (95%CI -2.5; -5.6). The trend varied in each state, although no increase in admissions was observed in any state. In both men and women, the highest reductions were observed in hospitalizations for gastrointestinal ulcers (-11.7% a year and -12.1%, respectively), avoidable conditions (-8.8% and -8.9%) and lower respiratory diseases (-8.0% and -8.1%). Hospitalization increased only for angina (men), kidney infections and urinary tract infections (men and women) and conditions related to prenatal care and delivery (women). The three groups of illness which led to the most admissions were infectious gastroenteritis and its complications, cardiac insufficiency and asthma.
  
  
  CONCLUSIONS
  Between 1998 and 2009, there was a substantial reduction in admissions for ambulatory care sensitive conditions in Brazil, although some illnesses presented stability or even an increase, which calls for attention from the health sector.
authors.affiliation: Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil. antonio.boing@ufsc.br
authors.forename: Antonio Fernando
authors.initials: AF
authors.lastname: Boing
authors.forename: Rafael Baratto
authors.initials: RB
authors.lastname: Vicenzi
authors.forename: Flávio
authors.initials: F
authors.lastname: Magajewski
authors.forename: Alexandra Crispim
authors.initials: AC
authors.lastname: Boing
authors.forename: Rodrigo Otávio
authors.initials: RO
authors.lastname: Moretti-Pires
authors.forename: Karen Glazer
authors.initials: KG
authors.lastname: Peres
authors.forename: Sheila Rubia
authors.initials: SR
authors.lastname: Lindner
authors.forename: Marco Aurélio
authors.initials: MA
authors.lastname: Peres
mesh_terms: D017677:Age Distribution; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007256:Information Systems; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013997:Time Factors