Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District

ABSTRACT Objectives: To describe the mortality coefficients of elderly due to primary care sensitive conditions, from 2008 to 2018, and determine its association with the coverage of the Primary Health Care (Family Health Strategy and Basic Care models) in the Federal District. Methods: Ecological time series of mortality in Federal District elderly, from 2008 to 2018. The Poisson regression model was applied, considering as significant those with p<0.05, with a CI of 95%. Results: There were 70,503 deaths. There was a decrease in the risk of death of elders due to cardiovascular diseases and diabetes. Higher primary care coverage decreased the chance of death by sensitive conditions, both in Basic Care (OR: 0.994, CI: 0.990-0.998) and in the Family Health Strategy (OR: 0.997, CI: 0.995-0.999). Conclusions: Primary Care coverage was associated with a lower chance of death of the elderly due to Ambulatory Care Sensitive Conditions, especially in Basic Care.

摘要
研究目的：明确2008至2018年老年人群因初级保健敏感病症（primary care sensitive conditions）的死亡系数，并分析其与联邦特区初级卫生保健（Primary Health Care，涵盖家庭健康策略（Family Health Strategy）与基础护理模式（Basic Care models））覆盖率的关联。
研究方法：本研究针对2008至2018年联邦特区老年人群的死亡数据开展生态学时间序列分析。采用泊松回归模型（Poisson regression model）进行统计分析，以P<0.05作为差异具有统计学意义的判定标准，同时报告95%置信区间（CI）。
研究结果：本研究共纳入70503例死亡病例。分析显示，老年人群因心血管疾病与糖尿病导致的死亡风险有所降低。更高的初级卫生保健覆盖率可降低老年人群因敏感病症死亡的发生风险：基础护理模式下的比值比（OR）为0.994，95%CI为0.990~0.998；家庭健康策略下的OR为0.997，95%CI为0.995~0.999。
研究结论：初级卫生保健覆盖率与老年人群因门诊医疗敏感病症（Ambulatory Care Sensitive Conditions）导致的死亡风险降低存在显著关联，其中以基础护理模式下的关联更为显著。