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Production of Services and Quality of Hospital Care in Southeastern State of Brazil: 1992-1995

The analysis shows a significant downward trend in the frequency of hospital admissions in the State of Rio de Janeiro, probably reflecting the deliberate withdraw of financial investments in this sector, which began in 1993. This reduction was selective with regard to age group distribution - being greater in the adult and elderly groups. The analysis has also shown that the teaching sector has steadily raised its admissions. The quality of care was analyzed through the sentinel event approach. For the State of Rio de Janeiro as a whole, the occurrence of avoidable deaths during the hospital admission process shows a weak overall tendency to decline as detected by the reduction of this kind of death in the private sub-sector. In public and teaching hospitals the frequency of avoidable deaths has remained stable. The frequency of maternal deaths has remained high and stable, while the number of cesarean sections shows a significant increase, despite the high figures observed at the beginning of the period.