Search

This study analyses expenditure trends in Hospitalizations for Ambulatory Care Sensitive Conditions (ACSCs) in children. It is an ecological time-series study, including hospitalizations of children under five in Bahia, between 2000 and 2012. We calculate the annual ACSC rates, as well as the total and average expenditure on these hospitalizations. We construct linear regression analysis models for the temporal trends. Between 2000 and 2012, 810,831 ACSC hospitalizations for the under-fives were recorded in Bahia. Hospitalization rates dropped 24.7% over this period, falling from 44.6 to 33.6 per 1,000 children. The total expenditure on such admissions is estimated to be 155.8 million Brazilian Reals. When we compare the first with the last year of the series, we note a reduction of 50.4% in total expenditure. The linear regression analysis demonstrates a reduction trend in average ACSC expenditure (β = -1.20, p = 0.014), (β = -3.45, p <0.01) and total expenditure (β = -0,46, p <0.01). Despite the reductions in these indicators, ACSC rates remain high, which has a significant impact on the volume of resources spent on avoidable hospitalizations. To this end, it is important to reduce ACSC expenditure, to both improve population health and reduce hospital costs.

The startup process of a membrane bioreactor inoculated with yeast biomass (Saccharomyces cerevisiae) and used in the treatment of landfill leachate was evaluated. The yeast membrane bioreactor (MBRy) was inoculated with an exogenous inoculum, a granulated active dry commercial bakers' yeast. The MBRy was successfully started up with a progressive increase in the landfill leachate percentage in the MBRy feed and the use of Sabouraud Dextrose Broth. The membrane plays an important role in the startup phase because of its full biomass retention and removal of organic matter. MBRy is a suitable and promising process to treat recalcitrant landfill leachate. After the acclimation period, the COD and NH 3 removal efficiency reached values of 72 ± 3% and 39 ± 2% respectively. MBRy shows a low membrane-fouling potential. The membrane fouling was influenced by soluble microbial products, extracellular polymeric substances, sludge particle size, and colloidal dissolved organic carbon.