Hospitalization costs for Ambulatory Care Sensitive Conditions: time Series 2008-2015

Keywords: Primary Health Care; Basic Health Services; Health Care Quality, Access, and Evaluation; Hospital Information Systems; Ecological Studies.


Objective: to evaluate the costs of hospitalizations for ambulatory care sensitive conditions in the 2008-2015 time series. Methods: ecological study with records of the Hospital Information System. The sample was composed of records of admissions for diagnoses of the Brazilian List hospitalizations for ambulatory care sensitive conditions. Polynomial regressions were used to analyze the temporal trend of rates. Results: there was a decrease in the rates per 10,000 inhabitants (67.38 to 51.99) (r2=0.9783; p<0.001). The most costly causes were asthma, heart failure, cystitis, and pneumonia. There was a decreasing trend in hospitalizations (β=-2.15; p<0.001) and expenditures (β=-2243.24; p=0.169). Conclusion: the diagnosis asthma caused greater expenses, while inflammatory disease of the cervix reached caused lower expenses. In the time series, there was a trend towards reduction of expenses evidenced by the difference between the highest cost in 2009 and the lowest in 2015.


Miranda GMD, Mendes ACG, Silva ALA. The challenge of organizing a universal and efficient National Health System in the Brazilian federal pact. Saúde Soc. 2017; 26(2):329-35. doi:

Barros FPC, Sousa MF. Equity: concepts, meanings and implications for the Brazilian National Health Sys Saúde Soc. 2016; 25(1):9-18. doi:

Barbosa ML, Celino SDM, Carneiro AG, Costa GMC. Health care provided by SUS: the experience of foreign students. Esc Anna Nery 2016; 20(4):e20160092. doi:

Rehem TCMSB, Ciosak SI, Egry EY. Primary Care Sensitive Hospitalization: users detect flaws on the access to services. Rev Esc Enferm USP. 2014; 48(Esp2):70-6. doi:

Santos LM, Gonçalves MA, Charles C. As despesas municipais em saúde impactam as Internações por Condições Sensíveis à Atenção Primária (ICSAP)? Uma análise em municípios de Minas Gerais. Rev Gestão Sistema Saúde. 2016; 5(1):62-75. doi:

Avelino CCV, Goyatá SLT, Nogueira DA, Rodrigues LBB, Siqueira SMS. Quality of primary health care: an analysis of avoidable hospitalizations in a Minas Gerais county, Brazil. Ciênc Saúde Coletiva. 2015; 20(4):1285-93. doi:

Costa LQ, Pinto Júnior EP, Silva MGC. Time trends in hospitalizations for Ambulatory Care Sensitive Conditions among children under five years old in Ceará, Brazil, 2000-2012. Epidemiol Serv Saúde. 2017; 26(1):51-60. doi:

Arruda JS, Dias da Costa JS. Hospitalizations for primary care sensitive conditions in Novo Hamburgo, Rio Grande do Sul. Rev Bras Med Fam Comunidade. 2017; 12(39):1-11. doi:

Ferreira JBB, Borges MJG, Santos LL, Forster AC. Internações por condições sensíveis à atenção primária à saúde em uma região de saúde paulista, 2008 a 2010. Epidemiol Serv Saúde. 2014; 23(1):45-56. doi:

Brasil VP, Costa JSD. Hospitalizations owing to ambulatory care sensitive conditions in Florianopolis, Santa Catarina, Brazil – an ecological study, 2001-2011. Epidemiol Serv Saúde. 2016; 25(1):75-84. doi:

Harrison MJ, Dusheiko M, Sutton M, Gravelle H, Doran T, Roland M. Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study. BMJ. 2014; 349:6423. doi:

Instituto Brasileiro de Geografia e Estatística (IBGE). Indicadores de Base Populacional [Internet]. 2019 [citado 2019 Ago 16]. Disponível em:

Prefeitura Municipal de Picos. Secretaria Municipal de Saúde de Picos. Plano Diretor do Município de Picos [Internet]. 2019 [citado 2019 ago 16]. Disponível em:!

Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Portaria nº 221, de 17 de abril de 2008. Define a lista brasileira de Internações por Condições Sensíveis à Atenção Primária. [Internet]. 2008 [citado 2019 Aug 16]. Disponível em:

Ministério da Saúde (BR). DATASUS. Dados de morbidade hospitalar do SUS (SIH/SUS) [Internet]. 2015 [citado 2019 Nov 01]. Disponível em:

Souza QK, Peixoto SV. Descriptive study on the evolution of hospitalization costs for ambulatory care sensitive conditions in Brazil, 2000-2013. Epidemiol Serv Saúde. 2017; 26(2):285-94.doi:

Soranz D, Pinto LF, Penna GO. Themes and Reform of Primary Health Care (RCAPS) in the city of Rio de Janeiro, Brazil. Ciênc Saúde Coletiva. 2016; 21(5):1327-38. doi:

Santos BV, Lima DS, Fontes CJF. Hospitalization for ambulatory care-sensitive conditions in the state of Rondônia, Brazil: a descriptive study of the period 2012-2016. Epidemiol Serv Saúde. 2019; 28(1):e2017497. doi:

Borges PKO, Schawb PM, Blanski CR, Floriano LSM, Lopes BG, Muller EV. Sensitive hospitalizations to primary care and care in the health care network. Rev Rene. 2016; 17(5):668-75. doi:

Conceição RS, Silveira GSP, Veiga AJP, Matta JMB. Air temperature and its relationship with some respiratory diseases in Victory Conquest – BA. Rev Geoaraguaia [Internet]. 2015 [cited Nov 1, 2019]; 5(2):69-81. Available from:

Research Article