Impact of expansion of primary care in child health: a population-based panel study in municipalities in the Brazilian Amazon

Abstract

OBJECTIVES: Considering the expansion of primary care in areas of difficult access in the Brazilian territory in recent decades, the aim of this study to evaluate the effect of the Family Health Strategy (FHS) expansion on hospitalisations due to ambulatory care-sensitive conditions (ACSCs) and mortality in children under 5 years of age in the state of Pará, Brazilian Amazon. METHODS: A longitudinal analysis from 2008 to 2017 was conducted for data collected from the SUS's database (DATASUS) using panel regression methods to determine the association between the expansion FHS coverage, ACSC rate, under 5 mortality rate and child mortality rate in municipalities of the state of Pará. RESULTS: There was an expansion of 40% of the population coverage of the FHS, in the same period there were 347 468.55 hospitalisations due to ASCSs of children under 5 years of age in the public health network in the state of Pará, which represented a reduction of almost 28% (p value <0001), and significant reduction of almost 57.67% in government hospital expenditures with hospitalisations between 2008 and 2017. In this period, there was also a significant decrease in the mortality rate in children under 5 years of age. CONCLUSIONS: Our findings reinforce the importance of the public health protection for the child population and the positive impacts of FHS in the state of Pará, in the Brazilian Amazon. The government actions aimed at reducing regional health disparities and the effort to strengthen primary care can improve health indicators of children and be an important strategy to developing countries.