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Author  |
Nunes, B.P.; Soares, M.U.; Wachs, L.S.; Volz, P.M.; Saes, M. de O.; Duro, S.M.S.; Thume, E.; Facchini, L.A. |
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Abstract |
OBJECTIVE: Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. METHODS: A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bage, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (>/= 2 and >/= 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. RESULTS: The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8-19.6) and 10.6% (95%CI 9.1-12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition' form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09-2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. CONCLUSIONS: The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases. OBJETIVO: Avaliar a associacao da multimorbidade, modelo de atencao basica e posse de plano de saude com hospitalizacao. METODOS: Estudo transversal de base populacional com 1.593 idosos (60 anos ou mais) residentes na zona urbana do municipio de Bage, Rio Grande do Sul. O desfecho foi a hospitalizacao no ano anterior a entrevista. A multimorbidade foi avaliada por meio de dois pontos de corte (>/= 2 e >/= 3). O modelo de atencao basica foi definido pela residencia em areas cobertas pela atencao tradicional ou da Estrategia Saude da Familia. A posse de plano de saude foi referida pelos idosos. Realizou-se analise bruta e ajustada por regressao de Poisson utilizando modelo hierarquizado. O ajuste incluiu variaveis demograficas, socioeconomicas, capacidades funcionais e de servicos de saude. RESULTADOS: A ocorrencia de hospitalizacao geral e nao cirurgica foi de 17,7% (IC95% 15,8-19,6) e 10,6% (IC95% 9,1-12,1), respectivamente. Idosos com multimorbidade hospitalizaram mais em comparacao com os idosos sem multimorbidade, independentemente da forma de operacionalizacao da exposicao. O plano de saude aumentou em 1,71 (IC95% 1,09-2,69) vezes a internacao hospitalar entre residentes nas areas da Estrategia Saude da Familia em comparacao aos idosos residentes nas areas tradicionais sem plano de saude. CONCLUSOES: A multimorbidade aumentou a ocorrencia de hospitalizacoes, principalmente aquelas nao cirurgicas. Idosos com plano de saude e residentes em areas de Estrategia Saude da Familia internaram mais, independentemente da presenca de multiplas doencas. |
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