Expenditure trends in ambulatory care sensitive conditions in the under-fives in Bahia, Brazil

Area of Science:

• Public Health
• Health Economics
• Pediatrics

Background:

• Ambulatory Care Sensitive Conditions (ACSCs) represent hospitalizations that could potentially be prevented with adequate outpatient care.
• Analyzing expenditure trends for pediatric ACSCs is crucial for understanding healthcare resource allocation and identifying areas for improvement.

Purpose of the Study:

• To analyze expenditure trends for hospitalizations due to Ambulatory Care Sensitive Conditions (ACSCs) in children under five in Bahia, Brazil, from 2000 to 2012.
• To assess the relationship between ACSC hospitalization rates and associated healthcare expenditures over time.

Main Methods:

• Ecological time-series study design.
• Inclusion of all hospitalizations for children under five in Bahia between 2000 and 2012.
• Calculation of annual ACSC rates, total, and average expenditure, with linear regression models for trend analysis.

Main Results:

• A total of 810,831 ACSC hospitalizations were recorded. Hospitalization rates decreased by 24.7% (44.6 to 33.6 per 1,000 children).
• Total expenditure on ACSC admissions was estimated at 155.8 million Brazilian Reals, with a 50.4% reduction in total expenditure from the first to the last year.
• Linear regression showed significant decreasing trends in average ACSC expenditure (β = -1.20, p = 0.014) and total expenditure (β = -0.46, p < 0.01).

Conclusions:

• Despite significant reductions in ACSC hospitalization rates and expenditures in children under five in Bahia, rates remain high.
• High rates of avoidable hospitalizations indicate a substantial impact on healthcare resource utilization.
• Further efforts are needed to reduce ACSC expenditure, aiming to improve population health outcomes and decrease overall hospital costs.