Factores asociados a la hospitalización por procesos sensibles a cuidados ambulatorios en los municipios
Hospitalization for ambulatory care sensitive conditions: analysis of related factors in municipalities
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"apellidos" => "Márquez-Calderón" "email" => array:1 [ 0 => "smarquez@easp.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.M." "apellidos" => "Rodríguez del Águila" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "Perea-Milla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Ortiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "C." "apellidos" => "Bermúdez-Tamayo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Escuela Andaluza de Salud Pública. Granada" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Virgen de las Nieves. Granada" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Costa del Sol. Marbella. Málaga. España" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Distrito Sanitario Santa Fe. Granada. España" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Escuela Andaluza de Salud Pública. Campus Universitario de Cartuja. Ap. Correos 2070. 18080 Granada. España." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hospitalization for ambulatory care sensitive conditions: analysis of related factors in municipalities" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-10-22" "fechaAceptado" => "2003-04-23" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec268705" "palabras" => array:3 [ 0 => "Atención primaria de salud" 1 => "Hospitalización" 2 => "Investigación en servicios sanitarios" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec268706" "palabras" => array:3 [ 0 => "Primary care" 1 => "Hospitalization" 2 => "Health services research" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir la variabilidad en las tasas de hospitalización por procesos sensibles a cuidados ambulatorios (PSCA) entre municipios del área de referencia de un hospital de tercer nivel, y determinar la influencia de las características de la atención primaria, los factores socioeconómicos, el nivel de salud de la población y la accesibilidad geográfica al hospital.</p> <span class="elsevierStyleSectionTitle">Método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio ecológico en 34 municipios del área del Hospital Virgen de las Nieves (Granada), abarcando todas las hospitalizaciones por PSCA de 1997 a 1999. Las tasas de hospitalización se calcularon por separado para varones y mujeres y se estandarizaron por el método indirecto según la edad. Se exploraron como variables independientes las siguientes: características de la atención primaria (tipo de modelo y centro), socioeconómicas (desempleo, renta, comercios, tamaño del municipio), de salud (mortalidad) y accesibilidad (crona: minutos desde el municipio al hospital). Se realizó un análisis de regresión lineal múltiple.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El 9,8% de los ingresos ocurridos en el hospital fueron por PSCA. La tasa media anual fue de 10 ingresos por 1.000 habitantes, siendo superior en varones y en los mayores de 74 años. En el 56% de los municipios las razones de hospitalización estandarizadas no fueron estadísticamente diferentes de 1, en un 26% fueron menores y en un 18%, mayores. Un 62% de la variabilidad en las tasas de los varones se explicó por la crona al hospital, el tamaño del municipio, la interacción entre ambas variables y la mortalidad. Las tasas en mujeres se explicaron en un 18% por la crona y la tasa de desempleo.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La variabilidad de las tasas de hospitalización por PSCA no se asoció a las características de la atención primaria en el ámbito geográfico estudiado. La mayor accesibilidad en tiempo al hospital fue la única variable asociada a mayores tasas en varones y mujeres. Las tasas en mujeres fueron superiores cuanto mayor era el desempleo, y las tasas en varones fueron más altas en los pueblos grandes y con mayor mortalidad.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe variability in admission rates for ambulatory care sensitive conditions (ASSC) in municipalities in the catchment area of a tertiary hospital and to determine the influence of primary care characteristics, socioeconomic factors, health of the population, and geographical accessibility to the hospital on this variability.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An ecological study was carried out in 34 municipalities in the area served by the <span class="elsevierStyleItalic">Hospital Virgen de las Nieves</span> in Granada (Spain) including all admissions for ASSC from 1997 to 1999. The admission rates for men and women were calculated separately and were age-standardized by the indirect method. The following factors were analyzed as independent variables: characteristics of primary care (type of healthcare model and type of center), socioeconomic factors (unemployment rate, income per capita, number of business establishments, size of municipality), health (mortality rate), and accessibility (time in minutes from the municipality to the hospital). A multiple lineal regression model was estimated.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 9.8% of all hospital admissions were due to ASSC. The mean annual admission rate was 10 admissions per 1.000 inhabitants. This rate was higher for men and for persons aged more than 74 years. The standardized admission ratios were not statistically different from 1 in 56% of the municipalities and were higher than 1 in 26% and lower than 1 in 18%. Sixty-two percent of the variability in rates for men was associated with time taken to reach the hospital, size of municipality, the interaction between both variables, and mortality. Eighteen percent of the variability in rates for women was associated with time taken to reach the hospital and the unemployment rate.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Variability in admission rates for ASSC was not associated with primary care characteristics in the geographical area analyzed. Accessibility (measured as time to the hospital) was the only variable associated with higher rates in both men and women. Admission rates for ASSC among women were higher when unemployment rates were higher, and rates among men were higher in larger municipalities and in those with higher mortality.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of socioeconomic status on hospital use in New York City" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Billings" 1 => "L. Zeitel" 2 => "J. Lukomnic" 3 => "T.S. Carey" 4 => "A.E. Blank" 5 => "L. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 4 | 10 |
| 2024 Octubre | 72 | 35 | 107 |
| 2024 Septiembre | 57 | 19 | 76 |
| 2024 Agosto | 57 | 28 | 85 |
| 2024 Julio | 36 | 24 | 60 |
| 2024 Junio | 37 | 13 | 50 |
| 2024 Mayo | 38 | 24 | 62 |
| 2024 Abril | 34 | 16 | 50 |
| 2024 Marzo | 37 | 20 | 57 |
| 2024 Febrero | 33 | 46 | 79 |
| 2024 Enero | 27 | 16 | 43 |
| 2023 Diciembre | 18 | 14 | 32 |
| 2023 Noviembre | 25 | 16 | 41 |
| 2023 Octubre | 22 | 10 | 32 |
| 2023 Septiembre | 21 | 10 | 31 |
| 2023 Agosto | 32 | 7 | 39 |
| 2023 Julio | 42 | 21 | 63 |
| 2023 Junio | 35 | 19 | 54 |
| 2023 Mayo | 45 | 14 | 59 |
| 2023 Abril | 26 | 17 | 43 |
| 2023 Marzo | 23 | 35 | 58 |
| 2023 Febrero | 25 | 20 | 45 |
| 2023 Enero | 24 | 18 | 42 |
| 2022 Diciembre | 32 | 29 | 61 |
| 2022 Noviembre | 53 | 46 | 99 |
| 2022 Octubre | 35 | 34 | 69 |
| 2022 Septiembre | 25 | 31 | 56 |
| 2022 Agosto | 33 | 59 | 92 |
| 2022 Julio | 27 | 46 | 73 |
| 2022 Junio | 29 | 42 | 71 |
| 2022 Mayo | 24 | 60 | 84 |
| 2022 Abril | 28 | 56 | 84 |
| 2022 Marzo | 27 | 75 | 102 |
| 2022 Febrero | 27 | 56 | 83 |
| 2022 Enero | 34 | 36 | 70 |
| 2021 Diciembre | 28 | 33 | 61 |
| 2021 Noviembre | 24 | 53 | 77 |
| 2021 Octubre | 36 | 46 | 82 |
| 2021 Septiembre | 20 | 33 | 53 |
| 2021 Agosto | 15 | 25 | 40 |
| 2021 Julio | 17 | 17 | 34 |
| 2021 Junio | 9 | 22 | 31 |
| 2021 Mayo | 21 | 23 | 44 |
| 2021 Abril | 59 | 61 | 120 |
| 2021 Marzo | 27 | 16 | 43 |
| 2021 Febrero | 24 | 10 | 34 |
| 2021 Enero | 16 | 21 | 37 |
| 2020 Diciembre | 21 | 11 | 32 |
| 2020 Noviembre | 13 | 15 | 28 |
| 2020 Octubre | 15 | 19 | 34 |
| 2020 Septiembre | 10 | 6 | 16 |
| 2020 Agosto | 13 | 14 | 27 |
| 2020 Julio | 8 | 9 | 17 |
| 2020 Junio | 16 | 12 | 28 |
| 2020 Mayo | 13 | 15 | 28 |
| 2020 Abril | 15 | 18 | 33 |
| 2020 Marzo | 8 | 6 | 14 |
| 2020 Febrero | 14 | 35 | 49 |
| 2020 Enero | 8 | 13 | 21 |
| 2019 Diciembre | 13 | 10 | 23 |
| 2019 Noviembre | 13 | 4 | 17 |
| 2019 Octubre | 10 | 5 | 15 |
| 2019 Septiembre | 7 | 6 | 13 |
| 2019 Agosto | 9 | 9 | 18 |
| 2019 Julio | 9 | 4 | 13 |
| 2019 Junio | 7 | 7 | 14 |
| 2019 Mayo | 10 | 6 | 16 |
| 2019 Abril | 8 | 7 | 15 |
| 2019 Marzo | 3 | 7 | 10 |
| 2019 Febrero | 6 | 6 | 12 |
| 2019 Enero | 0 | 5 | 5 |
| 2018 Diciembre | 4 | 7 | 11 |
| 2018 Noviembre | 13 | 14 | 27 |
| 2018 Octubre | 22 | 19 | 41 |
| 2018 Septiembre | 24 | 15 | 39 |
| 2018 Agosto | 14 | 9 | 23 |
| 2018 Julio | 27 | 11 | 38 |
| 2018 Junio | 24 | 8 | 32 |
| 2018 Mayo | 25 | 11 | 36 |
| 2018 Abril | 16 | 4 | 20 |
| 2018 Marzo | 17 | 8 | 25 |
| 2018 Febrero | 9 | 5 | 14 |
| 2018 Enero | 16 | 5 | 21 |
| 2017 Diciembre | 13 | 10 | 23 |
| 2017 Noviembre | 15 | 12 | 27 |
| 2017 Octubre | 9 | 6 | 15 |
| 2017 Septiembre | 13 | 7 | 20 |
| 2017 Agosto | 8 | 7 | 15 |
| 2017 Julio | 21 | 10 | 31 |
| 2017 Junio | 19 | 6 | 25 |
| 2017 Mayo | 27 | 13 | 40 |
| 2017 Abril | 22 | 6 | 28 |
| 2017 Marzo | 12 | 2 | 14 |
| 2017 Febrero | 7 | 1 | 8 |
| 2017 Enero | 10 | 3 | 13 |
| 2016 Diciembre | 31 | 3 | 34 |
| 2016 Noviembre | 27 | 10 | 37 |
| 2016 Octubre | 25 | 14 | 39 |
| 2016 Septiembre | 13 | 6 | 19 |
| 2016 Agosto | 35 | 9 | 44 |
| 2016 Julio | 16 | 0 | 16 |
| 2016 Enero | 3 | 0 | 3 |
| 2015 Diciembre | 1 | 0 | 1 |
| 2015 Octubre | 1 | 0 | 1 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Junio | 2 | 0 | 2 |
| 2015 Mayo | 1 | 0 | 1 |
| 2015 Abril | 2 | 0 | 2 |
| 2015 Marzo | 2 | 0 | 2 |
| 2015 Febrero | 2 | 0 | 2 |
| 2015 Enero | 1 | 0 | 1 |
| 2014 Diciembre | 1 | 0 | 1 |
| 2014 Noviembre | 4 | 0 | 4 |
| 2014 Octubre | 1 | 0 | 1 |
| 2014 Septiembre | 1 | 0 | 1 |
| 2014 Agosto | 6 | 0 | 6 |
| 2014 Julio | 8 | 0 | 8 |
| 2014 Junio | 4 | 0 | 4 |
| 2014 Mayo | 4 | 0 | 4 |
| 2014 Abril | 9 | 1 | 10 |
| 2014 Marzo | 3 | 2 | 5 |
| 2014 Febrero | 7 | 1 | 8 |
| 2014 Enero | 9 | 1 | 10 |
| 2013 Diciembre | 15 | 1 | 16 |
| 2013 Noviembre | 18 | 1 | 19 |
| 2013 Octubre | 22 | 2 | 24 |
| 2013 Septiembre | 14 | 4 | 18 |
| 2013 Agosto | 33 | 3 | 36 |
| 2013 Julio | 23 | 1 | 24 |
| 2003 Agosto | 1479 | 0 | 1479 |
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