Trends and spatial clustering of hospitalizations due to primary health care sensitive conditions in children under five years in Brazil, 2008–2022

Abstract

Objectives To evaluate the temporal trend and spatial cluster of hospitalizations due to primary health care sensitive conditions in children under 5 years old in Brazil, between 2008 and 2022. Study design Ecological study of temporal trends and spatial cluster conducted with data on hospitalizations in children under 5 years old in Brazil. Methods Data on hospitalizations due to primary health care sensitive conditions were included in the study in all Brazilian regions, disaggregated by states, regions, sex, and health conditions. Using data from the resident population, the standardized hospitalization rates were estimated and evaluated according to temporal trends by Prais-Winsten regression and spatial clusters by Hot Spot analysis. Results Between 2008 and 2022, 6,022,752 hospitalizations among children were recorded, with a significant decrease in rates throughout this period (p < 0.05). Hospitalizations due to immunization-preventable diseases and epilepsies were the only increasing rates. A negative relation was identified between the hospitalization rates in children under 5 years old and the coverage of the Family Health Strategy (p = 0.002), suggesting that the higher the coverage, the lower the hospitalization rates. The spatial clusters showed changes in the spatial distribution in the rate clusters. Conclusion The patterns of hospitalizations in children under 5 years old changed over the 15 years of the time series, reflecting investments in primary health care. However, the increasing rates reflect the need for surveillance and strengthening of the health care network to care for this population.