Tendência das internações por doenças respiratórias sensíveis à atenção primária de menores de cinco anos no Brasil

Abstract

Health systems strongly oriented by primary health care (PHC) present better health outcomes, as well as lower costs and hospitalizations, and can lead to greater user satisfaction. To assist in assessing the access, quality and resolution of this level of care, the Brazilian List of Admissions for Primary Care Conditions (ICSAP) was instituted. Admissions for these conditions are defined as preventable by the implementation of preventive care and early treatment of diseases by PHC. Among the conditions listed as sensitive to primary care are respiratory diseases, such as bacterial pneumonia, asthma, lung diseases, and nose and throat infections. The objective of this study was to analyze the trend of hospitalization rates related to respiratory diseases sensitive to primary care (DRSAP) of children under five years in Brazil. This is a time-series study of hospitalization rates for DRSAP of children under five years of age residing in large Brazilian regions, from 2008 to 2017, using secondary information from the Hospital Information System. The causes of hospitalization considered for analysis were separated into groups of causes according to the Brazilian list of hospitalizations for attention-sensitive conditions (nose and throat infections, asthma, bacterial pneumonia and lung diseases). The rates were calculated by the total hospitalizations for DRSAP, cause group, age group and region. The trend analysis was performed through simple linear regression, and it can be considered a steady trend (p≥0.05), ascending (ꞵ positive and p <0.05), or declining (ꞵ negative and p <0.05). The group of bacterial pneumonias was stationary throughout Brazil, except in the Southeast for children under five, where there was an upward trend. Asthma had no upward trend in any region or age group. Hospital admissions for lung diseases and nose and throat infections showed upward trends in all age groups in the Northeast and Southeast regions. In other regions, there was a predominance of upward trends among the age groups. It is concluded that the trends of the total rates of hospitalization for DRSAP were stationary for all regions, except for the Southeast, which was upward. Asthma was the only cause group showing declining trends in most regions and / or age groups. Bacterial pneumonias showed stationary trends, while lung diseases and nose and throat infections exhibited a predominance of upward trends.