Reasons for Provider-to-Provider Synchronous Teleconsultations Between Nurses in Primary Care: A Cross-Sectional Study of TelessaúdeRS-UFRGS Service.

Introduction: Nurses have proven to be fundamental for the expansion and consolidation of primary health care (PHC), as well as the development of digital health strategies. We explored the results of a synchronous telephone teleconsultations service between professionals for nurses in Brazil. Methods: This is a cross-sectional study. We retrieved data from teleconsultations registry. All teleconsultations answered by the team of nurses between September 2018 and July 2021 were analyzed regarding the reasons (according to International Classification of Primary Care, 2nd edition-ICPC-2) and decisions of the teleconsultation. Results: There were 9,273 phone teleconsultations registered in the period, requested by 3,125 nurses from all states throughout the country, of which 56.9% called once and 15.9% used the teleconsultations at least 4 times. We found 362 different reasons for solicitations, which were classified according to the ICPC-2 chapters. The most frequent codes were respiratory (25.9%), general and unspecified (21.2%), and skin (21.2%), which corresponded to 68% of the total sample. Most teleconsultations (66.9%) had as outcome the maintenance of the case at PHC. Conclusion: Teleconsultations are widely used and address a broad number of situations. This service may improve the quality of Brazilian PHC and promote the development of clinical reasoning and critical thinking by nurses.

Socio-demographic caracteristics and prevalence of risk factors in a hypertensive and diabetics population: a cross-sectional study in primary health care in Brazil.

BACKGROUND: Systemic arterial hypertension and diabetes mellitus, and their related morbidity and mortality, are currently the most common public health problems and also a higher burden of disease in Brazil. They represent a real challenge for primary health care. This study describes the methodology and baseline data of an adult population with hypertension and diabetes attending in primary health care. METHODS: It is a cross sectional study which presents data from a longitudinal research. 3784 adults were randomly selected from the registry of a health service in Porto Alegre, Brazil. The eligibility criteria were: confirmed diagnosis of hypertension and/or diabetes, consulted at least once in the prior 3 years and 18 years of age or older. Home data collection consisted of a questionnaire with information on demographic, medical history, life style and socio-economic factors. RESULTS: A total of 2482 users were interviewed (response rate of 71 %). The median age was 64 (IQR = 55.7) and the majority were women (68 %), and married (52 %). Whereas 66.5 % (CI 95 % 64.5-68.3) of the sample had only hypertension, 6.5 % (CI 95 % 5.5-7.5) had diabetes and 27.1 % (CI 95 % 25.3-28.8) had both diseases. The prevalence of diseases increased with age and with fewer years of study (p < 0.05). Subjects with both diseases had significantly more associated comorbidities. CONCLUSIONS: Hypertension and diabetes are more prevalent in older individuals, especially women, and less educated people. People suffering with both chronic conditions simultaneously are more likely to have additional comorbidities.

Effectiveness of motivational interviewing in smoking groups in primary healthcare: a community-based randomized cluster trial.

Smoking is the main cause of avoidable death and a major public health problem worldwide, with primary healthcare being a strategic setting for treating this problem. Aims: to evaluate the effectiveness of motivational interviewing associated with the cognitive behavioral therapy (CBT) in smoking groups in primary healthcare. A community-based cluster randomized clinical trial was conducted in Brazil, starting in July 2016. Professionals in the test group were trained in motivational interviewing for eight hours to associate it with the CBT. The usual treatment for smoking cessation in groups consists of four structured weekly sessions of 90 minutes each using a CBT. Taylor's linearization was used to correct the p-values; the chi-square test with Pearson correlation was used for categorical variables, and analysis of variance as well as the Student t-test were used for continuous variables. In total, 44 smoking groups were conducted, totaling 329 patients (178 in the motivational interviewing group and 151 in the control group). The smoking cessation rate with motivational interviewing was 61.8%, with RR = 1.25 (95%CI: 1.01-1.54, p = 0.043), and 47.7% in the control group, in the fourth weekly group treatment session. Mean session attendance was 3.1 (95%CI: 2.9-3.3) in the motivational interviewing group and 2.9 (95%CI: 2.5-3.4) in the control group. The completion rate for the motivational interviewing group was 65.2% and for the control group, 57.6%. Motivational interviewing associated with the CBT was shown to be effective and superior to only CBT to smoking cessation in groups in the fourth weekly session and for the population profile of the study (women with an average age of 50.6 years).

Hospitalisations due to ambulatory care sensitive conditions (ACSC) between 2009 and 2018 in Brazil's Federal District as compared with other state capitals. / Internações por Condições Sensíveis à Atenção Primária (ICSAP) no Distrito Federal: comparação com outras capitais brasileiras no período de 2009 a 2018.

This study compared standardised rates of hospitalisations due to ambulatory care sensitive conditions (ACSCs) in Brazil's Federal District from 2009 to 2018, as compared with those for selected state capitals, age groups and admissions groups. This ecological study used secondary data drawn from Hospital Information System microdata for the study period, during which, in the Federal District, the proportion of such admissions among 50-59 and 60-69 year olds declined, while those among children and adolescents held stable. Meanwhile, rates did not decrease in the ≤ 20 year age groups, a priority population in PHC, which may suggest that this population encountered barriers to access. The results showed that the expected reduction in the proportion of such admissions has not occurred, because coverage by Family Health Teams has been expanded only recently.

Este estudo tem como objetivo comparar para a última década, as taxas padronizadas de internações por condições sensíveis à atenção primária à saúde (ICSAP) no Distrito Federal (DF), cotejando-as com capitais selecionadas, faixa etária e grupos ICSAP. Trata-se de um estudo ecológico com dados secundários oriundos dos microdados do Sistema de Informações Hospitalares (SIH-SUS), para o período de 2009 a 2018. Nesse intervalo, houve redução da participação relativa das ICSAP nas faixas etárias de 50 a 59 e 60 a 69 anos e estabilidade na proporção dessas internações entre crianças e adolescentes no DF. Por outro lado, a não redução nas faixas etárias ≤ 20 anos, uma população prioritária na APS, pode representar barreiras de acesso dessa população. Os resultados evidenciam a não observação dos efeitos esperados de redução na proporção das ICSAP, devido ao fato da expansão de cobertura de Equipes de Saúde da Família ter sido recente.

Strengthening Primary Health Care in the municipalities in the Metropolitan Region of Porto Alegre, Brazil, after the introduction of the Mais Médicos (More Doctors) Program: an inter-municipal comparison. / O fortalecimento da Atenção Primária à Saúde nos municípios da Região Metropolitana de Porto Alegre, Brasil, após a inserção no Programa Mais Médicos: uma comparação intermunicipal.

This article aims to propose an adaptation of the methodology used by Starfield and Shy (2002) to assess the quality of health care in the municipalities which joined the Mais Médicos (More Doctors) Program. The indicators were adapted for each one of the nine criteria proposed in the methodology and were applied to medium and large municipalities in the Metropolitan Region of Porto Alegre before and after they were integrated in the Mais Médicos Program. In 2014, the municipalities were grouped into three groups according to their scores. An analysis concerning any correlations between the different group scores for the municipalities and the health indicators that were evaluated, did not reveal anything significant. However the averages of the evaluated indicators were better in the group of municipalities characterized through having the best APS scores. In relation to the income indicator, the highest amount of money spent per capita in health is related to the best APS performance in the municipalities. An adaption of this methodology may be able to provide a better understanding of the policies related to health care.

Effectiveness of motivational interviewing in smoking groups in primary healthcare: a community-based randomized cluster trial / A efetividade da entrevista motivacional em grupos de tabagistas na atenção primária: um estudo randomizado de clusters comunitários / Efectividad de las entrevistas motivacionales en grupos de fumadores dentro de la atención primaria: un ensayo grupal aleatorio basado en comunidades

Smoking is the main cause of avoidable death and a major public health problem worldwide, with primary healthcare being a strategic setting for treating this problem. Aims: to evaluate the effectiveness of motivational interviewing associated with the cognitive behavioral therapy (CBT) in smoking groups in primary healthcare. A community-based cluster randomized clinical trial was conducted in Brazil, starting in July 2016. Professionals in the test group were trained in motivational interviewing for eight hours to associate it with the CBT. The usual treatment for smoking cessation in groups consists of four structured weekly sessions of 90 minutes each using a CBT. Taylor's linearization was used to correct the p-values; the chi-square test with Pearson correlation was used for categorical variables, and analysis of variance as well as the Student t-test were used for continuous variables. In total, 44 smoking groups were conducted, totaling 329 patients (178 in the motivational interviewing group and 151 in the control group). The smoking cessation rate with motivational interviewing was 61.8%, with RR = 1.25 (95%CI: 1.01-1.54, p = 0.043), and 47.7% in the control group, in the fourth weekly group treatment session. Mean session attendance was 3.1 (95%CI: 2.9-3.3) in the motivational interviewing group and 2.9 (95%CI: 2.5-3.4) in the control group. The completion rate for the motivational interviewing group was 65.2% and for the control group, 57.6%. Motivational interviewing associated with the CBT was shown to be effective and superior to only CBT to smoking cessation in groups in the fourth weekly session and for the population profile of the study (women with an average age of 50.6 years).

O tabagismo é a principal causa de morte evitável, e é um problema de saúde pública global. A atenção primária representa um contexto estratégico para enfrentar o problema. O objetivo foi avaliar a efetividade da entrevista motivacional associada à terapia cognitiva-comportamental (TCC) em grupos de tabagistas tratados na atenção primária. Foi realizado um estudo clínico randomizado de clusters comunitários, iniciado em julho de 2016. Os profissionais no grupo experimental foram treinados durante 8 horas na técnica de entrevista motivacional , com o propósito de associar a técnica à TCC. O tratamento usual para cessação de tabagismo em grupos consiste em quatro sessões estruturadas com duração de 90 minutos, uma por semana, com o uso da TCC. Foi aplicada a linearização de Taylor para corrigir os valores de p; o teste qui-quadrado de Pearson foi usado para variáveis categóricas e análise de variância, e o teste t de Student para variáveis contínuas. Foram organizados 44 grupos de tabagistas, com um total de 329 pacientes (178 no grupo entrevista motivacional e 151 no grupo controle). A taxa de cessação do tabagismo com entrevista motivacional foi 61,8%, com RR = 1,25 (IC95%: 1,01-1,54; p = 0,043), comparado com 47,7% no grupo controle, depois da quarta sessão semanal de terapia de grupo. A média de frequência foi de 3,1 sessões (IC95%: 2,9-3,3) no grupo entrevista motivacional e 2,9 (IC95%: 2,5-3,4) no grupo controle. A proporção de participação integral nas sessões foi 65,2% no gruo entrevista motivacional e 57,6% no grupo controle. A entrevista motivacional associada à TCC mostrou ser efetiva e superior à TCC isoladamente para cessação de tabagismo em grupos com quatro sessões semanais e para o perfil da população do estudo (mulheres com média de idade de 50,6 anos).

Fumar es la principal causa de muerte evitable, y uno de los mayores problemas de salud pública alrededor del mundo, siendo la atención primaria un eje estratégico para el tratamiento de este problema. El objetivo fue evaluar la efectividad de las entrevistas motivacionales, asociadas con la terapia comportamental cognitiva (TCC), en grupos de fumadores dentro de la atención primaria. El ensayo clínico grupal aleatorio basado en comunidades se realizó en Brasil, empezó en julio de 2016. Los profesionales en el grupo de prueba fueron entrenados en entrevistas motivacionales durante 8 horas para asociarlo con el TCC. El tratamiento habitual para dejar de fumar en grupos consistía en cuatro sesiones semanales, estructuradas en 90 minutos cada una, usando la TCC. Se aplicó la linealización de Taylor para corregir los valores de p; el test de chi-cuadrado con la correlación de Pearson se usó para las variables categóricas y se utilizaron el análisis de variancia y el test Student t para las variables continuas. Se monitorizaron 44 grupos de fumadores, totalizando 329 pacientes (178 en el entrevistas motivacionales grupo y 151 en el grupo de control). La tasa de abandono del tabaco con entrevistas motivacionales fue 61,8%, con RR = 1,25 (95%CI: 1,01-1,54; p = 0,043), y 47,7% en el grupo de control, en la cuarta sesión grupal de tratamiento semanal. La media de asistencia a sesiones fue 3,1 (95%CI: 2,9-3,3) en el grupo entrevistas motivacionales y 2,9 (95%CI: 2,5-3,4) en el grupo de control. La tasa de finalización para el grupo entrevistas motivacionales fue 65,2%, y para el grupo de control 57,6%. Las entrevistas motivacionales asociadas con la TCC demostró ser efectiva y superior para solamente la TCC de abandonar el tabaco en grupos en la cuarta sesión semanal y para el perfil de la población en estudio (mujeres con una media de edad de 50,6 años).

Agradecimento aos Revisores da RBMFC em 2020 / Acknowledgment of all those who reviewed for RBMFC in 2020 / Reconocimiento a los revisores de la RBMFC en 2020

A Revista Brasileira de Medicina de Família e Comunidade (RBMFC) agradece aos Avaliadores listados abaixo que atuaram como revisores ad hoc durante o ano de 2020, dedicando horas voluntariamente para a emissão de pareceres técnicos sobre manuscritos submhttps://fi-admin.bvsalud.org/utils/field_assist/abstract/#etidos a esta revista.

Internações por Condições Sensíveis à Atenção Primária (ICSAP) no Distrito Federal: comparação com outras capitais brasileiras no período de 2009 a 2018 / Hospitalisations due to ambulatory care sensitive conditions (ACSC) between 2009 and 2018 in Brazil's Federal District as compared with other state capitals

Resumo Este estudo tem como objetivo comparar para a última década, as taxas padronizadas de internações por condições sensíveis à atenção primária à saúde (ICSAP) no Distrito Federal (DF), cotejando-as com capitais selecionadas, faixa etária e grupos ICSAP. Trata-se de um estudo ecológico com dados secundários oriundos dos microdados do Sistema de Informações Hospitalares (SIH-SUS), para o período de 2009 a 2018. Nesse intervalo, houve redução da participação relativa das ICSAP nas faixas etárias de 50 a 59 e 60 a 69 anos e estabilidade na proporção dessas internações entre crianças e adolescentes no DF. Por outro lado, a não redução nas faixas etárias ≤ 20 anos, uma população prioritária na APS, pode representar barreiras de acesso dessa população. Os resultados evidenciam a não observação dos efeitos esperados de redução na proporção das ICSAP, devido ao fato da expansão de cobertura de Equipes de Saúde da Família ter sido recente.

Abstract This study compared standardised rates of hospitalisations due to ambulatory care sensitive conditions (ACSCs) in Brazil's Federal District from 2009 to 2018, as compared with those for selected state capitals, age groups and admissions groups. This ecological study used secondary data drawn from Hospital Information System microdata for the study period, during which, in the Federal District, the proportion of such admissions among 50-59 and 60-69 year olds declined, while those among children and adolescents held stable. Meanwhile, rates did not decrease in the ≤ 20 year age groups, a priority population in PHC, which may suggest that this population encountered barriers to access. The results showed that the expected reduction in the proportion of such admissions has not occurred, because coverage by Family Health Teams has been expanded only recently.

Estratégia Saúde da Família, um forte modelo de Atenção Primária à Saúde que traz resultados / The Family Health Strategy, a strong model of Primary Health Care that delivers results

RESUMO Este artigo revisa e sintetiza evidências sobre o impacto da Estratégia Saúde da Família (ESF) a partir do marco conceitual de sistemas de saúde da Organização Mundial da Saúde, o qual agrega os conceitos de acesso, proteção financeira, qualidade dos serviços, eficiência no sistema, impacto na saúde e equidade. Os resultados sugerem que a ESF contribuiu para a melhoria em todos esses indicadores, com alguns efeitos no acesso e equidade com resultados quase chegando aos níveis observados nos países da Organização para Cooperação e Desenvolvimento Econômico. Embora ainda haja bastante espaço para melhorias, a evidência é clara de que a ESF é uma abordagem poderosa e eficaz para a organização da atenção primária à saúde no Brasil.(AU)

ABSTRACT This article uses the health systems framework of the World Health Organization to review and synthesize evidence on the impact of the Family Health Strategy (FHS) within the concepts of access, financial protection, quality of services, system efficiency, health impact, and equity. The results suggest that the FHS contributed to the improvement in all those indicators, with effects on access and equity nearly at the level observed in the countries of the Organization for Economic Cooperation and Development. Although there is still great room for improvement, the evidence is clear that the FHS is a powerful and effective approach to the organization of primary health care in Brazil.(AU)

Trends in hospitalizations for primary care sensitive conditions following the implementation of Family Health Teams in Belo Horizonte, Brazil.

OBJECTIVES: How to provide effective and efficient care to the burgeoning and aging populations of the major cities of low- and middle-income countries constitutes one of the principle public health issues of our times. We evaluated the Family Health Strategy, the Brazilian national health system's public approach to primary health care, in the major city of Belo Horizonte, describing trends and factors associated with hospitalizations for primary care sensitive conditions following the implementation of 506 family health teams, most of which were established in 2002. METHODS: We conducted an ecological study covering 2003 to 2006, using mixed models to investigate time trends in public system hospitalizations as well as their association with social vulnerability and primary care team characteristics. RESULTS: Sensitive conditions accounted for 115,340 (26.4%) hospitalizations. Over the 4-year period, hospitalizations for sensitive conditions declined by 17.9%, vs only 8.3% for non-sensitive ones (P<0.001). Hospitalization for sensitive conditions declined 22% for women in areas of high social vulnerability vs 9% for women in areas of low vulnerability (P<0.001); for men, 17% vs 10% (P=0.11). CONCLUSIONS: Though the ecologic nature of our study limits the confidence with which conclusions can be affirmed, the Family Health Strategy appears to have contributed to a major reduction in hospitalizations due to primary care sensitive conditions in this large Brazilian metropolis, while at the same time promoting greater health equity.

O fortalecimento da Atenção Primária à Saúde nos municípios da Região Metropolitana de Porto Alegre, Brasil, após a inserção no Programa Mais Médicos: uma comparação intermunicipal / Strengthening Primary Health Care in the municipalities in the Metropolitan Region of Porto Alegre, Brazil, after the introduction of the Mais Médicos (More Doctors) Program: an inter-municipal comparison

Resumo Este artigo visa propor uma adaptação da metodologia utilizada por Starfield e Shy (2002) para avaliar a qualidade da atenção primária em saúde (APS) dos municípios que aderiram ao Programa Mais Médicos. Os indicadores foram adaptados para cada um dos nove critérios propostos na metodologia original e aplicados para os municípios de médio e grande porte da Região Metropolitana de Porto Alegre, antes e depois destes integrarem o Programa Mais Médicos. Em 2014, os municípios foram agregados em três grupos, conforme seus escores. As análises de correlações entre diferentes grupos de escores dos municípios e os indicadores de saúde avaliados não se mostraram significativas, porém, as médias dos indicadores avaliados são melhores no grupo de municípios caracterizados com os melhores escores da APS. Em relação aos indicadores de renda, os maiores gastos per capita em saúde estão relacionados à melhor performance da APS nesses municípios. A adaptação desta metodologia pode indicar melhor compreensão das políticas relacionadas à determinação da saúde.

Abstract This article aims to propose an adaptation of the methodology used by Starfield and Shy (2002) to assess the quality of health care in the municipalities which joined the Mais Médicos (More Doctors) Program. The indicators were adapted for each one of the nine criteria proposed in the methodology and were applied to medium and large municipalities in the Metropolitan Region of Porto Alegre before and after they were integrated in the Mais Médicos Program. In 2014, the municipalities were grouped into three groups according to their scores. An analysis concerning any correlations between the different group scores for the municipalities and the health indicators that were evaluated, did not reveal anything significant. However the averages of the evaluated indicators were better in the group of municipalities characterized through having the best APS scores. In relation to the income indicator, the highest amount of money spent per capita in health is related to the best APS performance in the municipalities. An adaption of this methodology may be able to provide a better understanding of the policies related to health care.

[Family Health, more than never!]. / Saúde da Família, agora mais do que nunca!

The implementation of Primary Health Care as a strategy for organizing health care is undoubtedly important. There are already sufficient evidences that countries whose health systems are organized from the principles of Primary Care achieve better results on health with lower costs, higher level of user satisfaction and greater equity even in situations of great social inequity such as in Brazil. Strengthening Primary Care in Brazil has been a gradual process, showed with the expansion of the coverage of Family Health teams in all states of the federation, nowadays we have 29,148 of family health teams, 228,412 community health workers and 17,588 oral health teams working throughout the country. There are multiple studies on Family Health Strategy showing positive results that let no doubt about the success of this strategy. Despite all the advances, challenges were placed ahead, the most important are: the challenge of training and permanent education, the challenge of consolidating the PHC as system's coordinator and the challenge of communicating with society. We are on track, meet the challenges mentioned is an obligation of Brazilian society in the maintenance of greater social inclusion's policy, which is the Unified Health System driven by the primary care/Family Health Strategy.

[Ambulatory care sensitive hospitalizations: elaboration of Brazilian list as a tool for measuring health system performance (Project ICSAP--Brazil)]. / Internações por condições sensíveis à atenção primária: a construção da lista brasileira como ferramenta para medir o desempenho do sistema de saúde (Projeto ICSAP--Brasil).

Ambulatory care sensitive hospitalizations are a set of conditions for which access to effective primary care can reduce the likelihood of hospitalization. These hospitalizations have been used as an indicator of primary care performance in several countries and in three Brazilian states, but there is little consensus on which conditions should be included in this indicator. This paper presents a description of the steps undertaken to construct and validate a list for Brazil. The final list includes 20 groups of diagnostic conditions that represented 28.3% of a total of 2.8 million hospitalizations in the National Unified Health System in 2006. Gastroenteritis and complications, congestive heart failure, and asthma represented 44.1% of all ambulatory care sensitive hospitalizations. From 2000 to 2006, ambulatory care sensitive hospitalizations decreased by 15.8%, and this reduction was more significant than that observed in all other hospitalizations. The article concludes with potential applications and limitations of the proposed Brazilian list.

Saúde da Família, agora mais do que nunca / Family Health, more than never

A implantação da atenção primária como uma estratégia de organização dos sistemas de saúde tem relevância inquestionável. Já existem evidências suficientes que os países cujos sistemas de saúde se organizam a partir dos princípios da atenção primária alcançam melhores resultados em saúde com menores custos, maior satisfação dos usuários e maior equidade, mesmo em situações de grande desigualdade social, como é o caso do Brasil. O fortalecimento da atenção primária no Brasil tem sido um processo gradativo, traduzido no aumento de cobertura das equipes de Saúde da Família em todos os estados da federação, sendo que hoje temos 29.678 equipes de saúde da família, 229.572 agentes comunitários e 18.220 equipes de saúde bucal atuando em todo o país. Os resultados positivos nas avaliações da Saúde da Família são múltiplos e não deixam dúvida do sucesso da estratégia. Apesar de todos os avanços, alguns desafios estão postos para o futuro; entre eles, destacam-se o desafio da formação e educação permanente, o desafio de consolidar a atenção primária à saúde (APS) como ordenadora do sistema e o desafio da comunicação com a sociedade. Estamos no caminho certo, vencer os desafios apontados é obrigação da sociedade brasileira na manutenção de sua maior política de inclusão social, que é o Sistema Único de Saúde orientado pela atenção primária/Saúde da Família.

The implementation of Primary Health Care as a strategy for organizing health care is undoubtedly important. There are already sufficient evidences that countries whose health systems are organized from the principles of Primary Care achieve better results on health with lower costs, higher level of user satisfaction and greater equity even in situations of great social inequity such as in Brazil. Strengthening Primary Care in Brazil has been a gradual process, showed with the expansion of the coverage of Family Health teams in all states of the federation, nowadays we have 29,148 of family health teams, 228,412 community health workers and 17,588 oral health teams working throughout the country. There are multiple studies on Family Health Strategy showing positive results that let no doubt about the success of this strategy. Despite all the advances, challenges were placed ahead, the most important are: the challenge of training and permanent education, the challenge of consolidating the PHC as system's coordinator and the challenge of communicating with society. We are on track, meet the challenges mentioned is an obligation of Brazilian society in the maintenance of greater social inclusion's policy, which is the Unified Health System driven by the primary care/Family Health Strategy.

Internações por condições sensíveis à atenção primária: a construção da lista brasileira como ferramenta para medir o desempenho do sistema de saúde (Projeto ICSAP - Brasil) / Ambulatory care sensitive hospitalizations: elaboration of Brazilian list as a tool for measuring health system performance (Project ICSAP - Brazil)

As internações por condições sensíveis à atenção primária representam condições de saúde que podem ter o risco de hospitalização desnecessária diminuído, por meio de ações efetivas da atenção primária. Essas internações vêm sendo usadas como indicador do acesso e qualidade da atenção básica, mas não existe consenso quanto às doenças que devem fazer parte desse indicador. Apresenta-se uma descrição das etapas seguidas para a construção da lista brasileira de internações por condições sensíveis à atenção primária. A lista final é composta por vinte grupos de diagnósticos, que representavam 28,3 por cento das hospitalizações realizadas pelo Sistema Único de Saúde em 2006, em um total de cerca de 2,8 milhões de internações. Gastroenterites e complicações, insuficiência cardíaca e asma corresponderam a 44,1 por cento. De 2000 a 2006, as internações por condições sensíveis à atenção primária caíram 15,8 por cento no país, e o declínio dessas hospitalizações foi maior do que as internações não-internações por condições sensíveis à atenção primária. São discutidas as aplicações e limites da lista nacional de internações por condições sensíveis à atenção primária.

Ambulatory care sensitive hospitalizations are a set of conditions for which access to effective primary care can reduce the likelihood of hospitalization. These hospitalizations have been used as an indicator of primary care performance in several countries and in three Brazilian states, but there is little consensus on which conditions should be included in this indicator. This paper presents a description of the steps undertaken to construct and validate a list for Brazil. The final list includes 20 groups of diagnostic conditions that represented 28.3 percent of a total of 2.8 million hospitalizations in the National Unified Health System in 2006. Gastroenteritis and complications, congestive heart failure, and asthma represented 44.1 percent of all ambulatory care sensitive hospitalizations. From 2000 to 2006, ambulatory care sensitive hospitalizations decreased by 15.8 percent, and this reduction was more significant than that observed in all other hospitalizations. The article concludes with potential applications and limitations of the proposed Brazilian list.