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FONTENELLE, Leonardo Ferreira. Family Health Strategy and Hospitalizations by Ambulatory Care-Sensitive Conditions (ACSC): systematic review of the literature. 2011. 44 f. Dissertation (Master) – Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2011. OBJECTIVE: To verify if the adoption of the Family Health strategy (ESF; formerly named Family Health Program, PSF) is associated with lower rates, odds or risk of hospitalization by ambulatory care sensitive conditions (ACSC), compared to the traditional Brazilian primary health care (PHC) model. MATERIALS & METHODS: A systematic review of the scientific literature using the terms ('family health program' or 'familial health strategy') and ('sensitive conditions' or 'sensitive hospitalizations'), as well as the corresponding terms in Portuguese. The was no publication date limit, but the search was restricted to original research testing whether if there's an association between the PHC model and hospitalizations by ACSC in the general population. The data sources included MEDLINE, LILACS and IBECS, through PubMed and Biblioteca Virtual em Saúde (BVS). The methodological quality was not used as an exclusion criterion, but to explore eventual divergences in the results. The assessment instrument was a checklist with 10 items, proposed by Downs & Black and adapted by Nedel et al. RESULTS: 82 unique citations were found, but only 4 of them matched the inclusion criteria. The studies have variable methodological approaches, but all of them found some association between ESF and hospitalizations by ACSC. This association changed with age, sex, ACSC group, and municipality size. DISCUSSION: Family Health was associated with less hospitalizations by ACSC, specially in the female sex, in the elderly, and for cardiovascular conditions, respiratory conditions and diabetes mellitus. It may be necessary to run the analysis separately for each combination of age group, sex and ACSC group. Controlling or not the analysis for PHC quality should be explicitly decided on basis of a conceptual framework. Descriptors: Primary Health Care; Family Health; Community Health Services; Program Evaluation; Outcome Assessment (Health Care); Hospitalization. LISTA DE ABREVIATURAS E SIGLAS ACS Agente comunitário de saúde APS Atenção primária à saúde BVS Biblioteca Virtual em Saúde CID-10 Classificação Estatística Internacional de Doenças e Problemas Relacionados com a Saúde, 10a revisão CSAP Condições Sensíveis à Atenção Primária ESF Estratégia Saúde da Família EUA Estados Unidos da América FUNASA Fundação Nacional de Saúde IBECS Índice Bibliográfico Español en Ciencias de la Salud IC 95% Intervalo de confiança de 95% IDH Índice de Desenvolvimento Humano IPEA Instituto de Pesquisas Econômicas Aplicadas LILACS Literatura Latino-Americana e do Caribe em Ciências da Saúde MEDLINE Medical Literature Analysis and Retrieval System (MEDLARS) Online NOB/96 Norma Operacional Básica do Sistema Único de Saúde 01/1996 OMS Organização Mundial da Saúde PACS Programa de Agentes Comunitários de Saúde PNAB Política Nacional de Atenção Básica PNACS Programa Nacional de Agentes Comunitários de Saúde PSF Programa Saúde da Família RC Razão de chances (em inglês: “odds ratio”) RP Razão de probabilidades RR Risco relativo SAS Secretaria de Assistência à Saúde SUS Sistema Único de Saúde UNICEF Fundo das Nações Unidas pela Infância URSS União das Repúblicas Socialistas Soviéticas

Estratégia Saúde da Família e Internações por Condições Sensíveis à Atenção Primária (CSAP): revisão sistemática da literatura