Accessibility and care pathways for children admitted to hospital for ambulatory care sensitive conditions.

Abstract

The aim of this study was to analyze health service accessibility and the care pathways of children admitted to hospital for ambulatory care sensitive conditions (ACSCs). A cross-sectional study was conducted of a random sample of children hospitalized over a period of one year in a town in the north of Minas Gerais, Brazil. The Primary Care Assessment Tool Child Edition, adapted and validated for use in Brazil (PCAT-CE), was used to assess accessibility and interviews were conducted with the children s carers to determine the pathway taken to hospitalization. Of the 376 pediatric hospitalizations assessed, 109 (28.9%) were classified as ACSC admissions. Health service accessibility and utilization scores were low for both the ACSC and non-ACSC groups. No statistically significant differences (p<0.05) were found between the two groups. The care pathways reveal that most families visited hospitals as the first service and that visits to other health services were frequent. Well over half (63.3%) of the families of children admitted for ACSCs did not seek primary health services at any time. Accessibility was poor among the study group, regardless of the reason that led to hospitalization. The care pathways reveal an irregular pattern of service utilization for children admitted for ACSCs, suggesting a fragile health care network.