Primary care-sensitive hospitalization conditions in children under the age of 1 in Brazil

Area of Science:

• Pediatric Health Services Research
• Public Health Surveillance
• Healthcare Epidemiology

Background:

• Primary care-sensitive condition hospitalizations (PCSCH) are critical indicators of healthcare system performance.
• Understanding hospitalization trends in infants is vital for targeted public health interventions.
• Brazil's diverse healthcare landscape necessitates detailed analysis of infant PCSCH.

Purpose of the Study:

• To analyze the temporal trends of PCSCH in Brazilian children under one year old.
• To examine age-specific trends within the neonatal and postneonatal subgroups.
• To identify key causes of PCSCH across different infant age groups.

Main Methods:

• Ecological, time-series study design.
• Calculation of PCSCH rates for infants (<1 year), neonates, and post-neonates.
• Application of the Prais-Winsten generalized linear model and Annual Percent Change (APC) for trend analysis.

Main Results:

• Infectious gastroenteritis was the primary cause of PCSCH in infants under one year.
• Congenital syphilis and infections dominated newborn hospitalizations; gastroenteritis was prevalent in post-newborns.
• A significant increase in newborn PCSCH rates was observed, contrasting with decreases in postneonatal and overall infant rates.

Conclusions:

• Distinct trends in hospitalization rates between neonatal and postneonatal periods suggest differing underlying risk factors.
• Public health strategies should consider age-specific determinants influencing infant hospitalizations.
• Continued monitoring of PCSCH is essential for evaluating and improving child healthcare in Brazil.