The impact of residency training in family medicine on hospital admissions due to Ambulatory-care Sensitive Conditions in Rio de Janeiro

Bibliographic Data

ID19593782
AuthorsAdelson Guaraci Jantsch (0000-0002-3012-5619, Universidade do Estado do Rio de Janeiro, corresponding author), Bo Burström (0000-0001-5770-9422, Karolinska Institutet, corresponding author), Gunnar H Nilsson (0000-0001-7811-7602, Karolinska Institutet, corresponding author), Antonio C M Ponce De Leon (0000-0002-0704-5215, Karolinska Institutet, corresponding author), Antônio Ponce De Leon
EditorsChaisiri Angkurawaranon (0000-0003-4206-9164)
Year2023
Volume3
Issue10
Pagese0000547
Publication date2023-10-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000547
PMID37851646
OpenAlexW4387737142
LanguageEN
References cited24

Lack of skilled human resources in primary care remains a major concern for policymakers in low- and middle-income countries. There is little evidence supporting the impact of residency training in family medicine in the quality of care, and it perpetuates misconceptions among policymakers that the provision of primary care can be easily done by any physician without special training. This article compares the risk of patients being hospitalized due to Ambulatory care sensitive conditions and the odds of having follow-up visits in primary care after hospital discharge, according to the type of their medical provider: (1) Generalists (reference), (2) Family physicians; and, (3) patients with no consultations prior to the event. Multilevel multivariate binomial regression models estimated the relative risks of a patient being hospitalized in a given month and the relative risks for the occurrence of a follow-up visit in primary care in a retrospective cohort of 636.640 patients between January 2013 and July 2018 in Rio de Janeiro. For all 14 conditions, there was a higher risk of hospitalization when patients had no consultation in primary care prior to the event. Except for Ear, Nose and Throat infections, patients seen by family physicians had a lower risk of being hospitalized, compared to patients seen by Generalists. Follow-up visits were more likely to happen among patients treated by family physicians for almost every condition analyzed. With two years of training in family medicine, Family physicians can reduce the risk of their patients being hospitalized and increase the likelihood of those patients having a follow-up consultation in primary care. Investments in residency training in family medicine should be made to fix the shortage of skilled physicians in primary care, reduce hospitalizations and improve quality and continuity of care

Ambulatory · Ambulatory care · Cohort · Confidence interval · Family medicine · Health care · Logistic regression · Odds · Odds ratio · Primary care · Relative risk · Residency training · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Primary Care and Health Outcomes · Emergency Medicine · Internal Medicine

Tools

Open DOIOpen Access