Evidence map›Paper›PMID 29208614›Full record

ArticleBMJ open2017

Association between hospitalisation for ambulatory care-sensitive conditions and primary health care physician specialisation: a cross-sectional ecological study in Curitiba (Brazil).

Marcelo P D Afonso, Helena E Shimizu, Edgar Merchan-Hamann, Walter M Ramalho, Tarcisio Afonso

Abstract read
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Article
  2. Article
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  4. Observational
  5. Article
  6. Article
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  9. Remembering Alma-Ata: challenges and innovations in primary health care in a middle-income city in Latin America.Revista panamericana de salud publica = Pan American journal of public health · 2018
    Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Marcelo P D AfonsoDepartamento de Saúde Coletiva, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.
Helena E ShimizuDepartamento de Saúde Coletiva, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.
Edgar Merchan-HamannDepartamento de Saúde Coletiva, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.
Walter M RamalhoDepartamento de Saúde Coletiva, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.
Tarcisio AfonsoPrograma de Mestrado Profissional, Fundação Pedro Leopoldo, Pedro Leopoldo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHospitalisation for ambulatory care-sensitive conditions (HACSCs) is frequently used as an indicator of the quality and effectiveness of primary healthcare (PHC) services around the world. The aim of the present study was to evaluate whether the PHC model (family health strategy (FHS) x conventional) and the availability of specialised PHC physicians is associated or not with total hospitalisation or HACSCs in the National Health System (SUS) of the municipality of Curitiba, Paraná state (PR), Brazil. METHODOLOGY: This is a cross-sectional ecological study using multiple linear regression with socioeconomic and professional data from municipal health units (MHUs) between 1 April 2014 and 31 March 2015.

resultsAfter adjustment for age and sex and control of socioeconomic variables, the FHS model was associated with six fewer HACSCs a year per 10 000 inhabitants in relation to the conventional model and the availability of one family physician at each FHS model MHU per 10 000 inhabitants was associated with 1.1 fewer HACSCs for heart failure a year per 10 000 inhabitants. Basic specialists (clinicians, paediatricians and obstetrician/gynaecologists) and subspecialists showed no significant association with HACSC rates.

conclusionThese results obtained in a major Brazilian city reinforce the role of FHS as a priority PHC model in the country and indicate the potentially significant impact of specialising in family medicine on improving the health conditions of the population.

Indexed as

Ambulatory CareAdolescentAdultAgedBrazilChildChild, PreschoolCross-Sectional StudiesFemaleHospitalizationHumansInfantMaleMiddle AgedPhysicians, Primary CarePrimary Health CareEpidemiologyPrimary CarePublic Health

Identifiers

PMID29208614
PMCPMC5719282

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.