PT  - JOURNAL ARTICLE
AU  - Bonfim, Samile
AU  - Massago, Miyoko
AU  - de Carvalho Dutra, Amanda
AU  - Arruda, Matheus Henrique Beltrame
AU  - Oliveira, Fernanda Silva
AU  - Thomaz, Érika Bárbara Abreu Fonseca
AU  - de Souza, Eniuce Menezes
AU  - Nihei, Oscar Kenji
AU  - de Andrade, Luciano
TI  - Hospitalizations for Cardiovascular Diseases Sensitive to Primary Health Care in Paraná State, Brazil: A Bayesian Spatiotemporal Model
AID  - 10.1370/afm.3083
DP  - 2024 Mar 01
TA  - The Annals of Family Medicine
PG  - 140--148
VI  - 22
IP  - 2
4099  - http://www.annfammed.org/content/22/2/140.short
4100  - http://www.annfammed.org/content/22/2/140.full
SO  - Ann Fam Med2024 Mar 01; 22
AB  - PURPOSE To analyze spatiotemporal trends in hospitalizations for cardiovascular diseases (CVD) sensitive to primary health care (PHC) among individuals aged 50-69 years in Paraná State, Brazil, from 2014 to 2019 and investigate correlations between PHC services and the Social Development Index.METHODS We conducted a cross-sectional ecological study using publicly available secondary data to analyze the municipal incidence of hospitalizations for CVD sensitive to PHC and to estimate the risk of hospitalization for this group of diseases and associated factors using hierarchical Bayesian spatiotemporal modeling with Markov chain Monte Carlo simulation.RESULTS There was a 5% decrease in the average rate of hospitalizations for PHC-sensitive CVD from 2014 to 2019. Regarding standardized hospitalization rate (SHR) according to population size, we found that no large municipality had an SHR >2. Likewise, a minority of these municipalities had SHR values of 1-2 (33%). However, many small and medium-sized municipalities had SHR values >2 (47% and 48%, respectively). A greater Social Development Index value served as a protective factor against hospitalizations, with a relative risk of 0.957 (95% credible interval, 0.929-0.984).CONCLUSIONS The annual risk of hospitalization decreased over time; however, small municipalities had the greatest rates of hospitalization, indicating an increase in health inequity. The inverse association between social development and hospitalizations for CVD sensitive to PHC raises questions about intersectionality in health care.