Impact of the Family Health Program on gastroenteritis in children in Bahia, Northeast Brazil: An analysis of primary care-sensitive conditions

Laura J. Monahan; Gregory S. Calip; Patricia M. Novo; Mark Sherstinsky; Mildred Casiano; Eduardo Mota; Inês Dourado

doi:10.1016/j.jegh.2013.03.002

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Volume 3, Issue 3, September 2013, Pages 175 - 185

Impact of the Family Health Program on gastroenteritis in children in Bahia, Northeast Brazil: An analysis of primary care-sensitive conditions

Authors

Laura J. Monahan^a^{, b}^,laura.monahan@nyumc.org, Gregory S. Calip^b^{, c}^{, d}^{, *}^,gcalip@fhcrc.org calip@u.washington.edu, Patricia M. Novo^b^{, e}^,patricia.novo@nyumc.org, Mark Sherstinsky^b^{, f}, Mildred Casiano^b^,mc3327@gmail.com, Eduardo Mota^g^,emota@ufba.br, Inês Dourado^g^,maines@ufba.br

^aDivision of Pediatric Critical Care, New York University School of Medicine, 462 1st Avenue, Suite 8S7-8, New York, NY 10016, United States

^bNew York University, Global Institute of Public Health, 240 Greene Street, 2nd Floor, New York, NY 10003, United States

^cDepartment of Epidemiology, University of Washington School of Public Health, University of Washington, Box 357263, Seattle, WA 98195, United States

^dDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-B402, Seattle, WA 98109, United States

^eDepartment of Psychiatry, New York University School of Medicine, 423 East 23rd Street, Suite 17015W, New York, NY 10010, United States

^fState University of New York College of Optometry, 33 West 42nd Street, New York, NY 10036, United States

^gInstitute of Collective Health (Instituto de Saúde Coletiva), Federal University of Bahia (UFBA), Rua Basílio da Gama, Campus Universitário Canela, Cep: 40.110-040, Salvador, BA, Brazil

^*Corresponding author. Address: Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-B402, Seattle, WA 98109-1024, United States. Tel.: +1 206 667 3209; fax: +1 206 667 7850.

Corresponding Author

Gregory S. Calipgcalip@fhcrc.org calip@u.washington.edu

Received 16 January 2013, Revised 4 March 2013, Accepted 7 March 2013, Available Online 13 April 2013.

DOI: 10.1016/j.jegh.2013.03.002 How to use a DOI?
Keywords: Family Health Program (Programa Saúde da Família; (PSF); National Unified Health System (Sistema Único de Saúde; (SUS); Pediatric gastroenteritis; Primary care
Abstract: In seeking to provide universal health care through its primary care-oriented Family Health Program, Brazil has attempted to reduce hospitalization rates for preventable illnesses such as childhood gastroenteritis. We measured rates of Primary Care-sensitive Hospitalizations and evaluated the impact of the Family Health Program on pediatric gastroenteritis trends in high-poverty Northeast Brazil. We analyzed aggregated municipal-level data in time-series between years 1999–2007 from the Brazilian health system payer database and performed qualitative, in-depth key informant interviews with public health experts in municipalities in Bahia. Data were sampled for Bahia’s Salvador microregion, a population of approximately 14 million. Gastroenteritis hospitalization rates among children aged less than 5 years were evaluated. Declining hospitalization rates were associated with increasing coverage by the PSF (P = 0.02). After multivariate adjustment for garbage collection, sanitation, and water supply, evidence of this association was no longer significant (P = 0.28). Qualitative analysis confirmed these findings with a framework of health determinants, proximal causes, and health system effects. The PSF, with other public health efforts, was associated with decreasing gastroenteritis hospitalizations in children. Incentives for providers and more patient-centered health delivery may contribute to strengthening the PSF’s role in improving primary health care outcomes in Brazil.
Open Access: Open access under CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

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<Previous Article In Issue

Journal: Journal of Epidemiology and Global Health
Volume-Issue: 3 - 3
Pages: 175 - 185
Publication Date: 2013/04/13
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.1016/j.jegh.2013.03.002 How to use a DOI?
Open Access: Open access under CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

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ris enw bib

TY  - JOUR
AU  - Laura J. Monahan
AU  - Gregory S. Calip
AU  - Patricia M. Novo
AU  - Mark Sherstinsky
AU  - Mildred Casiano
AU  - Eduardo Mota
AU  - Inês Dourado
PY  - 2013
DA  - 2013/04/13
TI  - Impact of the Family Health Program on gastroenteritis in children in Bahia, Northeast Brazil: An analysis of primary care-sensitive conditions
JO  - Journal of Epidemiology and Global Health
SP  - 175
EP  - 185
VL  - 3
IS  - 3
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2013.03.002
DO  - 10.1016/j.jegh.2013.03.002
ID  - Monahan2013
ER  -

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