• Samile Bonfim, Miyoko Massago, Amanda de Carvalho Dutra, Matheus Henrique Beltrame Arruda, Fernanda Silva Oliveira, Érika Bárbara Abreu Fonseca Thomaz, Eniuce Menezes de Souza, Oscar Kenji Nihei, and Luciano de Andrade.
• Postgraduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil samileenf@gmail.com.
• Ann Fam Med. 2024 Mar 1; 22 (2): 140148140-148.

PurposeTo analyze spatiotemporal trends in hospitalizations for cardiovascular diseases (CVD) sensitive to primary health care (PHC) among individuals aged 50-69 years in Paraná State, Brazil, from 2014 to 2019 and investigate correlations between PHC services and the Social Development Index.MethodsWe conducted a cross-sectional ecological study using publicly available secondary data to analyze the municipal incidence of hospitalizations for CVD sensitive to PHC and to estimate the risk of hospitalization for this group of diseases and associated factors using hierarchical Bayesian spatiotemporal modeling with Markov chain Monte Carlo simulation.ResultsThere was a 5% decrease in the average rate of hospitalizations for PHC-sensitive CVD from 2014 to 2019. Regarding standardized hospitalization rate (SHR) according to population size, we found that no large municipality had an SHR >2. Likewise, a minority of these municipalities had SHR values of 1-2 (33%). However, many small and medium-sized municipalities had SHR values >2 (47% and 48%, respectively). A greater Social Development Index value served as a protective factor against hospitalizations, with a relative risk of 0.957 (95% credible interval, 0.929-0.984).ConclusionsThe annual risk of hospitalization decreased over time; however, small municipalities had the greatest rates of hospitalization, indicating an increase in health inequity. The inverse association between social development and hospitalizations for CVD sensitive to PHC raises questions about intersectionality in health care.© 2024 Annals of Family Medicine, Inc.

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