Primary care-sensitive conditions among patients with healthcare-associated infections in Brazil: associations with hospital characteristics, clinical outcomes and costs
1
Post-Graduation Program in Health and Environment, University of the Joinville Region, Joinville, Brazil
2
Health and Services Department, Federal Institute of Santa Catarina, Joinville, Brazil
3
Teaching and Research Center, Unimed Hospital Center, Joinville, Brazil
4
Executive Office, Grupo IAG Saúde, Belo Horizonte, Brazil
5
Data Science Division, Grupo IAG Saúde, Belo Horizonte, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1818
ABSTRACT
INTRODUCTION:
Hospitalizations due to primary care–sensitive conditions (PCSCs) are widely used as indicators of primary healthcare performance and care coordination within health systems, particularly in low and middle-income countries facing structural constraints and high hospital demand. However, their relevance among patients with healthcare-associated infections (HAIs) remains insufficiently explored. This study aimed to analyze the association between PCSCs and hospital characteristics, clinical outcomes and costs among patients with HAIs in Brazil.
METHODS:
A retrospective observational study was performed using anonymized hospital discharge data from public and private hospitals adopting the Brazilian version of the diagnosis-related groups system (DRG Brazil). A total of 19060 adult hospitalizations involving HAIs (6400 PCSCs and 12660 non-PCSCs) from 2019, 2023, and 2024 were analyzed. PCSCs were identified using International Classification of Diseases, 10th revision, codes. Severity of illness was obtained from refined-DRG Brazil levels. Cost analyses were restricted to 1199 hospitalizations with valid cost information (371 PCSCs and 828 non-PCSCs). Statistical analyses included bivariate tests and multivariate models, comprising logistic regression, parametric survival models and generalized linear models with gamma distribution and log link.
RESULTS:
PCSCs constituted 33.58% of hospitalizations with HAIs. Higher proportions were observed among older patients, women, emergency admissions and public municipal hospitals with significant regional variation. PCSC hospitalizations presented significantly higher disease severity. After adjustment, PCSC hospitalizations were associated with lower in-hospital mortality (adjusted OR = 0.75; 95%CI: 0.70 – 0.81) and shorter length of stay (time ratio = 0.91; p < 0.001). No significant adjusted differences were observed in total or daily hospital costs. Severity of illness, length of stay and markers of care intensity were the main cost drives.
CONCLUSIONS:
Strengthening primary health care may reduce hospital burden even among complex inpatient populations, such as patients with HAIS, reinforcing the relevance of PCSCs as a systems-level performance indicator.
Hospitalizations due to primary care–sensitive conditions (PCSCs) are widely used as indicators of primary healthcare performance and care coordination within health systems, particularly in low and middle-income countries facing structural constraints and high hospital demand. However, their relevance among patients with healthcare-associated infections (HAIs) remains insufficiently explored. This study aimed to analyze the association between PCSCs and hospital characteristics, clinical outcomes and costs among patients with HAIs in Brazil.
METHODS:
A retrospective observational study was performed using anonymized hospital discharge data from public and private hospitals adopting the Brazilian version of the diagnosis-related groups system (DRG Brazil). A total of 19060 adult hospitalizations involving HAIs (6400 PCSCs and 12660 non-PCSCs) from 2019, 2023, and 2024 were analyzed. PCSCs were identified using International Classification of Diseases, 10th revision, codes. Severity of illness was obtained from refined-DRG Brazil levels. Cost analyses were restricted to 1199 hospitalizations with valid cost information (371 PCSCs and 828 non-PCSCs). Statistical analyses included bivariate tests and multivariate models, comprising logistic regression, parametric survival models and generalized linear models with gamma distribution and log link.
RESULTS:
PCSCs constituted 33.58% of hospitalizations with HAIs. Higher proportions were observed among older patients, women, emergency admissions and public municipal hospitals with significant regional variation. PCSC hospitalizations presented significantly higher disease severity. After adjustment, PCSC hospitalizations were associated with lower in-hospital mortality (adjusted OR = 0.75; 95%CI: 0.70 – 0.81) and shorter length of stay (time ratio = 0.91; p < 0.001). No significant adjusted differences were observed in total or daily hospital costs. Severity of illness, length of stay and markers of care intensity were the main cost drives.
CONCLUSIONS:
Strengthening primary health care may reduce hospital burden even among complex inpatient populations, such as patients with HAIS, reinforcing the relevance of PCSCs as a systems-level performance indicator.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
