Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District.
Geraldo Marques da Costa, Helena Eri Shimizu, Mauro Niskier Sanchez
PMID 36542054WHAT IT FOUND
In Brazil's Federal District, 29.2% of elderly deaths were from conditions considered sensitive to outpatient care.
The reported chance of dying from these conditions fell as primary care coverage rose, but this cannot prove coverage caused the decline.
Key findings
01Of the 70,503 elderly deaths analyzed, 29.2% were from conditions considered sensitive to outpatient care.
02Family Health Strategy coverage rose from 14% of Basic Care in 2008 to 89% in 2018, and the paper's risk measure, which relates deaths from these conditions to all elderly deaths in the same year, fell from 0.86 to 0.68 in 2017 and 2018.
03In adjusted analysis, a 10% increase in Basic Care coverage was associated with a 6% lower odds of death from these conditions, and a 10% increase in Family Health Strategy coverage was associated with a 3% lower odds.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an ecological study of population death records and coverage data, so it cannot show that primary care coverage caused lower elderly deaths. The authors say other unmeasured factors may have influenced the decline in deaths from chronic conditions. Death certificate causes may be incomplete or inaccurate. People from neighboring cities may have used Federal District services and given inexact addresses, so some deaths may not belong to the local population. More than 16 thousand deaths were removed after exclusions, which may limit the analysis.
The easy way to misread this
Do not read the falling death measure as proof that increasing Family Health Strategy coverage caused fewer elderly deaths. This was an ecological study of death records and coverage over time, not a test of a service, and the authors say other factors may have influenced the trend.