Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil

Malta, Deborah Carvalho; Bernal, Regina Tomie Ivata; Lima, Margareth Guimarães; Araújo, Silvânia Suely Caribé de; Silva, Marta Maria Alves da; Freitas, Maria Imaculada de Fátima; Barros, Marilisa Berti de Azevedo

doi:10.1590/S1518-8787.2017051000090

Deborah Carvalho Malta

Departamento de Enfermagem Materno Infantil e Saúde Pública. Escola de Enfermagem. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil

Regina Tomie Ivata Bernal

Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil

Margareth Guimarães Lima

Departamento de Medicina Preventiva e Social. Faculdade de Ciências Médicas. Universidade Estadual de Campinas. Campinas, SP, Brasil

Silvânia Suely Caribé de Araújo

Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde. Secretaria de Vigilância em Saúde. Ministério da Saúde. Brasília, DF, Brasil

Marta Maria Alves da Silva

Hospital das Clínicas. Universidade Federal de Goiás. Goiânia, GO, Brasil

Maria Imaculada de Fátima Freitas

Departamento de Enfermagem Materno Infantil e Saúde Pública. Escola de Enfermagem. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil

Marilisa Berti de Azevedo Barros

Departamento de Medicina Preventiva e Social. Faculdade de Ciências Médicas. Universidade Estadual de Campinas. Campinas, SP, Brasil

Correspondence: Deborah Carvalho Malta. Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem – UFMG. Av. Alfredo Balena, 190, Santa Efigênia. 30130-100 Belo Horizonte, MG, Brasil. E-mail: dcmalta@uol.com.br

Authors’ Contribution: Conception of the study, first draft, literature review, data analysis and interpretation, and review of the manuscript: DCM. Conception of the study, statistical analysis, data analysis and interpretation, critical review of the manuscript: RTIB. Conception of the study, literature review, data analysis and interpretation, critical review of the manuscript: MGL, MBAB. Data analysis, critical review of the manuscript: MMAS, MIFF. All authors approved the final version and take public responsibility for the article’s content.

Conflict of Interest: The authors declare no conflict of interest.

Variable	Population with NCD		Population without NCD		Crude PR^a	Adjusted PR^b	95%CI
Total	%		%
Use of health services in the last two weeks	25.64		10.87		2.36	2.02	1.88–2.18
Hospitalization in the last 12 months	9.61		4.91		1.96	1.7	1.53–1.9
Failing to perform activities in the last two weeks for health reasons	12.92		4.06		3.18	3.1	2.78–3.46
Medical consultation in the last 12 months	84.96		65.36		1.3	1.26	1.24–1.28
Males	%	Adjusted PR (95%CI)^c	%	Adjusted PR (95%CI)^c
Use of health services in the last two weeks	20.89	1	8.31	1	2.52	2.1	1.86–2.38
Hospitalization in the last 12 months	8.69	1	3.05	1	2.85	2.14	1.78–2.58
Failing to perform activities in the last two weeks for health reasons	10.73	1	3.63	1	2.95	2.73	2.28–3.27
Medical consultation in the last 12 months	78.69	1	56.96	1	1.38	1.31	1.26–1.35
Females
Use of health services in the last two weeks	28.93	1.38 (1.27–1.51)	13.67	1.65 (1.48–1.84)	2.12	1.96	1.8–2.14
Hospitalization in the last 12 months	10.24	1.18 (1.04–1.34)	6.94	2.28 (1.90–2.74)	1.48	1.5	1.31–1.72
Failing to perform activities in the last two weeks for health reasons	14.45	1.34 (1.20–1.50)	4.53	1.25 (1.04–1.50)	3.19	2.92	2.53–3.38
Medical consultation in the last 12 months	89.31	1.13 (1.11–1.16)	74.51	1.31 (1.27–1.35)	1.2	1.18	1.16–1.2

Variable	Population without NCD	Population with NCD – number of morbidities				Prevalence ratios^a

	(0)	1	2	3	4 or more	1/0	2/0	3/0	4/0
Total
Use of health services in the last two weeks (%) J14	10.87	20.06	26.65	37.28	46.56	1.72 (1.58–1.87)	2.17 (1.97–2.39)	2.91 (2.62–3.23)	3.46 (3.09–3.87)
Hospitalization in the last 12 months (%) J37	4.91	7.15	10.44	13.57	19.30	1.38 (1.20–1.58)	1.94 (1.68–2.24)	2.44 (2.03–2.93)	3.33 (2.75–4.04)
Failing to perform activities in the last two weeks for health reasons (%) J2	4.06	9.06	13.31	21.16	28.23	2.18 (1.92–2.48)	3.19 (2.79–3.65)	5.03 (4.25–5.95)	6.62 (5.56–7.90)
Medical consultation in the last 12 months (%) J11 = 01	65.36	79.95	89.15	92.78	96.45	1.19 (1.16–1.21)	1.29 (1.26–1.32)	1.32 (1.28–1.35)	1.33 (1.30–1.37)
Males
Use of health services in the last two weeks (%) J14	8.31	16.24	21.69	38.10	43.02	1.79 (1.55–2.07)	2.21 (1.87–2.62)	3.71 (3.09–4.47)	4.00 (3.15–5.07)
Hospitalization in the last 12 months (%) J37	3.05	6.16	9.55	15.55	23.50	1.71 (1.35–2.15)	2.39 (1.89–3.03)	3.60 (2.65–4.90)	5.18 (3.58–7.49)
Failing to perform activities in the last two weeks for health reasons (%) J2	3.63	8.31	11.12	17.89	26.00	2.25 (1.83–2.77)	3.05 (2.14–3.84)	4.92 (3.64–6.66)	7.19 (5.09–10.15)
Medical consultation in the last 12 months (%) J11 = 01	56.96	73.39	84.47	91.15	92.13	1.25 (1.21–1.29)	1.39 (1.33–1.45)	1.47 (1.41–1.54)	1.46 (1.37–1.55)
Females
Use of health services in the last two weeks (%) J14	13.67	23.17	29.97	36.85	47.78	1.66 (1.50–1.84)	2.11 (1.89–2.36)	2.57 (2.26–2.91)	3.29 (2.90–3.73)
Hospitalization in the last 12 months (%) J37	6.94	7.95	11.03	12.54	17.87	1.20 (1.01–1.43)	1.73 (1.45–2.06)	2.00 (1.58–2.53)	2.89 (2.32–3.62)
Failing to perform activities in the last two weeks for health reasons (%) J2	4.53	9.67	14.77	22.86	28.99	2.13 (1.80–2.52)	3.26 (2.75–3.86)	5.06 (4.14–6.20)	6.46 (5.26–7.93)
Medical consultation in the last 12 months (%) J11 = 01	74.51	85.27	92.27	93.63	97.93	1.14 (1.11–1.17)	1.23 (1.20–1.25)	1.24 (1.20–1.28)	1.29 (1.26–1.32)

Variable	Population with NCD		Population without NCD		Crude PR^a	Adjusted PR^b	95%CI

	%	PR (95%CI)^c	%	PR (95%CI)^c
Possess health insurance
Use of health services in the last two weeks	29.91	1	13.95	1	2.14	1.93	1.70–2.18
Hospitalization in the last 12 months	10.87	1	6.03	1	1.80	1.54	1.22–1.93
Failing to perform activities in the last two weeks for health reasons	10.98	1	4.21	1	2.61	2.47	1.98–3.07
Medical consultation in the last 12 months	93.40	1	82.20	1	1.14	1.11	1.09–1.14
Do not possess health insurance
Use of health services in the last two weeks	24.10	0.86 (0.79–0.93)	9.96	0.76 (0.67–0.86)	2.42	2.06	1.88–2.25
Hospitalization in the last 12 months	9.15	0.85 (0.74–0.98)	4.58	0.76 (0.63–0.91)	2.00	1.76	1.56–1.99
Failing to perform activities in the last two weeks for health reasons	13.62	1.22 (1.07–1.40)	4.02	0.91 (0.73–1.12)	3.39	2.93	2.58–3.32
Medical consultation in the last 12 months	81.93	0.90 (0.89–0.91)	60.36	0.76 (0.74–0.78)	1.36	1.28	1.25–1.31

Variable	Population with NCD		Population without NCD		Crude PR^a	Adjusted PR^b

	%	PR (95%CI)^c	%	PR (95%CI)^c
Illiterate/Some elementary school
Use of health services in the last two weeks	26.28	0.91 (0.81–1.03)	10.50	0.81 (0.69–0.97)	2.50	2.28 (2.03–2.57)
Hospitalization in the last 12 months	10.63	1.04 (0.85–1.28)	5.08	1.22 (0.94–1.59)	2.09	2.05 (1.74–2.43)
Failing to perform activities in the last two weeks for health reasons	15.09	1.41 (1.16–1.72)	4.96	1.19 (0.89–1.59)	3.04	2.95 (2.46–3.55)
Medical consultation in the last 12 months (%) J11 = 01	84.42	0.91 (0.90–0.94)	56.55	0.75 (0.72–0.78)	1.49	1.43 (1.38–1.48)
Elementary school/Some high school
Use of health services in the last two weeks (%) J14	23.13	0.86 (0.74–1.00)	9.91	0.82 (0.68–0.99)	2.33	2.18 (1.86–1.48)
Hospitalization in the last 12 months (%) J37	8.73	0.96 (0.74–1.23)	4.81	1.10 (0.83–1.46)	1.82	1.63 (1.26–2.11)
Failing to perform activities in the last two weeks for health reasons (%) J2	11.86	1.20 (0.95–1.52)	3.62	0.85 (0.63–1.15)	3.28	3.22 (2.48–4.19)
Medical consultation in the last 12 months (%) J11 = 01	83.23	0.93 (0.90–0.96)	63.08	0.85 (0.81–0.88)	1.32	1.26 (1.21–1.32)
High School/Some higher education
Use of health services in the last two weeks (%) J14	24.75	0.94 (0.82–1.07)	10.62	0.85 (0.73–0.98)	2.33	2.21 (1.96–2.49)
Hospitalization in the last 12 months (%) J37	8.36	0.95 (0.75–1.21)	4.90	1.07 (0.83–1.39)	1.71	1.58 (1.30–1.92)
Failing to perform activities in the last two weeks for health reasons (%) J2	10.88	1.12 (0.91–1.38)	3.49	0.82 (0.65–1.04)	3.12	3.00 (2.49–3.61)
Medical consultation in the last 12 months (%) J11 = 01	84.08	0.95 (0.92–0.97)	68.73	0.90 (0.87–0.93)	1.22	1.20 (1.16–1.23)
Higher education degree
Use of health services in the last two weeks (%)	27.84	1	13.74	1	2.03	1.99 (1.71–2.32)
Hospitalization in the last 12 months (%)	9.15	1	4.70	1	1.95	1.91 (1.44–2.54)
Failing to perform activities in the last two weeks for health reasons (%)	9.83	1	4.17	1	2.36	2.36 (1.80–3.09)
Medical consultation in the last 12 months (%)	91.04	1	79.21	1	1.15	1.14 (1.11–1.18)

[1] Correspondence: Deborah Carvalho Malta. Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem – UFMG. Av. Alfredo Balena, 190, Santa Efigênia. 30130-100 Belo Horizonte, MG, Brasil. E-mail: dcmalta@uol.com.br

Brasil

Brasil

Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil

ABSTRACT

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