ArticleCadernos de saude publica2025
Avoidable hospitalizations for ambulatory care sensitive conditions in children under five years in Ecuador, 2000-2023.
Article in Cadernos de saude publica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Spatiotemporal trends of neglected tropical disease hospitalizations in Ecuador over 25-years from 2000 to 2024.PLoS neglected tropical diseases · 2026Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Avoidable hospitalizations due to ambulatory care sensitive conditions (ACSC) are an indirect indicator of primary health care quality and effectiveness of care coordination. This study aims to analyze the proportion and trends of hospital discharges for ACSCs (2000-2023) among children under five years, project rates through 2026, and compare standardized rates across cantons. We conducted an ecologic time-series analysis using Ecuador's national hospital discharge data for 20 ACSCs, as defined by the Pan-American Health Organization. Annual percentage changes were estimated using Joinpoint regression, and forecasts were generated with the Prophet package in R. Standardized morbidity ratios (SMRs) were used to compare rates across 221 cantons, based on Ecuador's population from the 2001, 2010, and 2022 censuses. Between 2000 and 2023, ACSCs accounted for 26.6% of all hospital discharges. The overall average of annual percent change increased by 2%, and by 6.8%, 6.4%, and 4.2% for respiratory diseases, urinary and skin infections, respectively. Gastrointestinal diseases declined by 1.9% annually. Significant changes in ACSC trends were observed during the following periods: 2000-2007; 2018-2021; and 2021-2023. No significant change occurred from 2008 to 2018. Projections indicated that ACSCs may still represent 20.3% of hospital discharges by 2026. Moreover, 5.4% of cantons consistently exceeded expected SMRs across all three census years analyzed. The rising ACSC rates during the early 2000s, marked by economic structural adjustment and limited public healthcare investment, contrasts with the decline observed during the COVID-19 pandemic. These findings underscore the need to strengthen primary care and public health planning.
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