Public policies reflected on hospitalizations for ambulatory care sensitive conditions: an ecological study in Sergipe-Brazil, 2008-2017

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Abstract Background: Hospitalization for Ambulatory Care Sensitive Conditions (HACSC) are an indicator of failure at this level of the health system. Since 2006, a series of actions have been taken in Brazil to promote Primary Health Care (PHC), a situation that has changed radically since 2014. To analyze the trend of the HACSC in Sergipe, in the period from 2008 to 2017. Methods: Ecological time-trend analysis. The data were extracted from the hospital admission authorizations on Hospital Information System in Brazilian Unified Health System. It was classified according to the Brazilian List of HACSC. The rates were standardized by the indirect method. Findings: There were 608,083 non-obstetric admissions and 125,497 HACSC (20.6%), with an overall rate of 5.8 admissions per thousand inhabitants (5.7 male and 5.8 female). The trend described a U-curve, decreasing from 2008 to 2011, with little oscillation from 2011 to 2014, rising from 2014 to 2017. The rate was considerably higher in men over the age of 70. Throughout the period, the most frequent causes were: gastroenteritis and complications (15.6%), kidney and urinary tract infection (9.4%), asthma (9.2%), heart failure (8.8%), cerebrovascular (8.1%), and diabetes mellitus (7.2%). Conclusion: The indicator improved in the initial period of the study, following the introduction of public policies that strengthened PHC, and worsened as they were withdrawn or neglected.

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