Ambulatory Care-Sensitive Hospitalizations Among Adults and Older Adults Analyzed by Diagnosis-Related Groups

Abstract Introduction : Hospitalizations for ambulatory care-sensitive conditions (ACSCs), identified through the Diagnosis-Related Groups (DRG) system, provide an important indicator of the quality and effectiveness of Primary Health Care (PHC). As the main entry point to Brazil's Health Care Network, PHC coordinates patient care, helps prevent acute complications of Chronic non-communicable diseases (NCDs), and reduces avoidable hospitalizations and healthcare costs. Objective : To evaluate Hospitalizations for ambulatory care-sensitive conditions among adults and older adults, focusing on the leading causes of admission and hospital length of stay. Methods : This epidemiological study analyzed secondary data from 916,676 hospital admissions involving adults and older adults (aged 18 years or older) treated in DRG-participating hospitals across all five regions of Brazil between 2018 and 2024. Descriptive analyses summarized the distribution of hospitalizations according to disease groups, causes of admission, and length of hospital stay. Results : Noncommunicable diseases accounted for the largest proportion of hospital admissions during the study period. Cerebrovascular diseases, hypertension, and heart failure were the leading causes of hospitalization. These conditions also showed the highest hospitalization rates and contributed substantially to prolonged hospital stays. Conclusion : Hospitalizations for ACSCs remain an important indicator of PHC performance. The findings reinforce the pivotal role of PHC in reducing avoidable hospitalizations, lowering healthcare costs, promoting population health, and upholding the right to health as a fundamental social right.