Hospitalizations sensitive to primary care as an evaluation indicator for the Family Health Strategy

Rev Saude Publica. 2009 Dec;43(6):928-36. doi: 10.1590/s0034-89102009005000080. Epub 2009 Dec 18.
[Article in English, Portuguese]


Objective: To identify variables associated with hospitalizations sensitive to primary care.

Methods: A hospital morbidity survey was conducted using a random sample of 660 patients hospitalized in clinical and surgical wards of hospitals that had service agreements with the Brazilian National Health System (SUS), in the municipality of Montes Claros, Southeastern Brazil, between 2007 and 2008. Interviews were held with patients and members of their families using a specific form, and the patients' medical files were investigated. The definition of conditions considered sensitive to primary care was based on the Ministry of Health's list. Associations shown by socioeconomic and health variables in relation to hospitalizations sensitive to primary care were analyzed using bivariate and multiple logistic regression analyses.

Results: The percentage of hospitalizations sensitive to primary care in the study group was 38.8% (n = 256). The variables that remained statistically associated with conditions considered sensitive to primary care were: previous hospitalization (OR = 1.62; 95% CI: 1.51;2.28); regular visits to healthcare units (OR = 2.20; 95% CI: 1.44;3.36); low schooling level (OR = 1.50; 95% CI: 1.02;2.20); health checks not performed by the family health team (OR = 2.48; 95% CI: 1.64;3.74); hospitalization requested by physicians who were not part of the family health team (OR = 2.25; 95% CI: 1.03;4.94); and age greater than or equal to 60 years (OR = 2.12; 95% CI: 1.45;3.09).

Conclusions: The variables associated with hospitalizations sensitive to primary care are particularly those relating to patients, such as age, schooling level and previous hospitalization, but regular health checks outside of the Family Health Strategy doubled the likelihood of hospitalization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brazil
  • Epidemiologic Methods
  • Family Health*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • National Health Programs / standards*
  • Primary Health Care / standards*
  • Quality Indicators, Health Care*
  • Socioeconomic Factors
  • Young Adult