Relationship between hospitalizations, deaths and service structure

Abstract Background The structuring of health services is a fundamental element to respond to the burden of chronic diseases. Objective To analyze the relationship between hospitalizations and deaths due to diseases of the circulatory system and the structure in health services. Method A cross-sectional study developed in the state of the Brazilian central-west was carried out with a health region composed of 17 municipalities and 1,112,792 inhabitants. The demographic, epidemiological and health structure dimensions were analyzed using descriptive statistics and Pearson's linear correlation. Results The mortality rate due to diseases of the circulatory system was 29.49%, higher than the findings in the country and in the center-west. There was a significant correlation between hospitalization for ischemic heart diseases and number of beds, and between hospitalization for diseases of the circulatory system and number of specialized services for each 10,000 inhabitants. Conclusion The differences found between hospitalizations and the existence of specialized services and beds indicate that the population that lives in municipalities with a complex service structure has more access to services and hospitalizations. The results demonstrate that there must be greater care in the conformation and offer of services in the Health Care Network for diseases of the circulatory system, aiming to ensure equity in the population's access to the agreed services.

背景
卫生服务体系构建是应对慢性病疾病负担的核心要素。
研究目的
分析循环系统疾病患者的住院与死亡情况，及其与卫生服务体系结构之间的关联。
研究方法
本研究为横断面研究（cross-sectional study），在巴西中西部地区开展，研究覆盖包含17个市镇、共计1112792名居民的卫生区域。研究采用描述性统计方法与皮尔逊线性相关分析（Pearson's linear correlation），对人口统计学、流行病学及卫生服务结构三大维度展开分析。
研究结果
循环系统疾病相关死亡率为29.49%，高于巴西全国及中西部地区的平均水平。研究发现，缺血性心脏病住院率与每万居民床位数存在显著相关性；循环系统疾病住院率与每万居民专科服务机构数量亦存在显著相关性。
研究结论
本次研究揭示的住院情况与专科服务配置、床位供给之间的差异表明，居住在服务体系较为完善的市镇的居民，能够更便捷地获取医疗服务，且住院率更高。本研究结果提示，在构建循环系统疾病相关医疗保健网络（Health Care Network）的过程中，需进一步优化服务布局与供给，以保障居民在医疗服务可及性方面的公平性。