Inequity in utilizing health services in the Brazilian Amazon: A population-based survey, 2015.
Int J Health Plann Manage
; 34(4): e1846-e1853, 2019 Oct.
Article
em En
| MEDLINE
| ID: mdl-31515900
BACKGROUND: Although Brazil has a public and universal healthcare system, utilization of health services is marked by social and regional discrepancies. OBJECTIVE: To assess the prevalence and factors associated with underutilization of healthcare services in the Brazilian Amazon. METHOD: Cross-sectional, population-based study. Adults aged over 18 years old were selected through probabilistic sampling. Underutilization of healthcare services was defined as never seeing a physician or a dentist. Poisson regression with robust variance was performed to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). A complex sample design was considered. RESULTS: A total of 4001 individuals were included, of which 419 (10.4%; 95% CI, 9.5-11.4%) never visited a physician or a dentist. In the adjusted analysis, underutilization was higher among poorer people (PR = 3.32; 95% CI, 2.16-5.11), men (PR = 1.34; 95% CI, 1.10-1.65), people with brown skin color (Brazilian mixed race; PR = 1.34; 95% CI, 1.02-1.76), and people who are separated (PR = 1.40; 95% CI, 1.01-1.94) and widowed (PR = 1.55; 95% CI, 1.02-2.37), when compared with the reference categories. Individuals with informal jobs, those who are retired, students/housewives, and unemployed people were more vulnerable to underutilization than formal workers (P < .04). CONCLUSION: Underutilization of healthcare services occurs in one-tenth of adults in Manaus Metropolitan Region and is associated with social and economic inequities.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aceitação pelo Paciente de Cuidados de Saúde
/
Disparidades em Assistência à Saúde
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
Limite:
Adolescent
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Adult
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Female
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Humans
/
Male
/
Middle aged
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Int J Health Plann Manage
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
/
SERVICOS DE SAUDE
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Reino Unido