Primary Care Sensitive Conditions in a Public Emergency Department in Belo Horizonte Before and During the COVID-19 Pandemic

Abstract

Objective: To analyze admissions of individuals with ambulatory care sensitive conditions to a large public emergency department in Belo Horizonte during the periods before and during the COVID-19 pandemic.
Method: This was a retrospective comparative observational census study using data from electronic medical record data from patients admitted to the emergency department of a teaching hospital in Belo Horizonte. The target population consisted of individuals with diagnoses classified as ambulatory care sensitive conditions (ACSCs) admitted between March 2019 and March 2021. Results: A total of 8,931 visits related to ACSCs were identified during the study period, corresponding to 198 monthly visits by women and 151,63 monthly visits by men. During the pandemic, compared with the pre-pandemic period, there was an increase in visits related to cerebrovascular diseases (from 16,97% to 21,21%), ear, nose, and throat infections (from 11,97% to 15,53%), and arterial hypertension (from 7,75% to 8,78%) (p<0,001), as well as an increase in discharge after care (p=0,041) and low-urgency and non-urgent visits (p<0,001).  Conclusion: There was an increase during the COVID-19 pandemic in visits related to ACSCs due to some chronic noncommunicable and infectious diseases, as well as low-urgency situations. The importance of Primary Health Care as the gateway to the Health Care Network is emphasized, especially after the reorganization of services following the reduction in COVID-19 cases.

Method: Cross-sectional study using data from electronic medical records of patients admitted to the emergency department of a teaching hospital in Belo Horizonte, from January 2019 to March 2021. The target population consisted of individuals diagnosed with Primary Care Sensitive Conditions (PCSC) who were admitted during the study period. Results: A total of 137,098 visits were identified, of which 9,946 (7.25%) were classified as PCSC. During the pandemic, there was an increase in discharges after care and a decrease in hospitalizations compared to the pre-pandemic period. A stabilization in emergency and very urgent visits was observed, along with an increase in less urgent and non-urgent visits compared to the years preceding the pandemic. An increase in visits related to non-communicable chronic diseases (cerebrovascular diseases, hypertension, and diabetes mellitus) and communicable diseases (ear, nose, and throat infections) was also observed during the pandemic compared to the pre-pandemic period.