Hospital beds are a scarce resource in Latin America and the Caribbean, yet many are taken up by patients whose conditions could be managed outside the hospital, for example in clinics or doctors’ offices, according to a new IDB analysis.
In the study, we assessed what share of hospitalizations could be avoided by more effective primary care: hospitalizations for so-called ambulatory care-sensitive conditions (ACSCs). This includes admissions for complications for chronic illnesses like diabetes and hypertension, as well as common infections such as urinary tract infections and gastroenteritis.
The share of hospitalizations due to these conditions indicates how much hospital use could be avoided through more effective primary care — or, put differently, how much hospital capacity could be freed up to treat patients who truly need inpatient care. It highlights opportunities to better align health services with population needs and improve efficiency across the system.
What the Data Tells Us About Hospitalizations
Drawing on more than 90 million public hospital discharges across eight countries between 2015 and 2019, the research finds that:
1. One in six hospitalizations could be avoided
On average around 17% of all public sector hospital discharges and hospital days in public hospitals in our study are due to conditions that could be prevented or managed through primary care. That means nearly one in every six hospitalizations is potentially avoidable. As the graph below shows, while there are some differences across countries—ranging from about 14% in Mexico and Chile to nearly 20% in Brazil, Colombia, El Salvador, Paraguay, and Peru—the overall share of preventable hospitalizations remains similar throughout the region.
2. Chronic Conditions Drive Most Preventable Hospitalizations
The study also finds that chronic non-communicable diseases (NCDs) — diabetes complications, cardiovascular conditions, and respiratory illnesses — consistently account for more than half of these preventable hospitalizations. Infectious diseases are the second most common cause of preventable hospitalizations, while maternal and nutritional conditions account for a much smaller share—typically less than 5% in all countries.
ACSCs as share of total discharges (2015-2019)
3. Where You Live Matters
Beyond the national numbers, there is substantial variation across regions in each country. In countries like Brazil, Ecuador, and El Salvador, some regions have more than double the rate of avoidable hospitalizations compared to others. That suggests that there is scope to reduce the share of hospitalizations for these conditions.
How Can Countries Reduce Preventable Hospitalizations?
While countries have expanded coverage and services, the persistence of avoidable hospitalizations points to gaps in quality, continuity, and responsiveness—especially for people living with chronic conditions or in poorer regions. Improving how hospitals are used starts with strengthening health systems to meet current population needs and prevent complications before they escalate. Making progress will require a broader view of primary care—not just clinics, but coordinated networks of prevention, diagnosis, and support.
Health systems can take several steps. First, focus on early detection and sustained management of chronic conditions, through stronger care coordination, better use of clinical guidelines, and task-shifting approaches. Second, improve access to diagnostics and medicines at the primary care level, particularly in underserved areas. Third, routinely monitor preventable hospitalizations to identify where gaps are largest and learn from high-performing regions. Reducing avoidable hospitalizations is not just about cost savings—it’s about delivering the kind of care that keeps patients healthier and out of the hospital. For more information, read the full study here.
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