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Original Articles • Rev. Saúde Pública 51 (suppl 2) • 2017 • https://doi.org/10.11606/S1518-8787.2017051007070 copy

Main characteristics of patients of primary health care services in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To characterize patients of primary health care services according to demographic and socioeconomic aspects, habits and lifestyle, health condition, and demand for health services and medicines.

METHODS

This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services), a cross-sectional study carried out between 2014 and 2015. Interviews were conducted with patients over the age of 17 years, with a standardized questionnaire, in primary health care services of a representative sample of cities, stratified by regions of Brazil. The analysis was performed for complex samples and weighted according to the population size of each region.

RESULTS

A total of 8,676 patients were interviewed, being 75.8% women, most of them aged from 18 to 39 years; 24.2% men, most of them aged from 40 to 59 years; 53.7% with elementary school; 50.5% reported to be of mixed race ethnicity, 39.7%, white, and 7.8%, black. Half of patients were classified as class C and 24.8% received the Bolsa Familia benefit. Only 9.8% had health insurance, with higher proportion in the South and lower in the North and Midwest. The proportion of men who consumed alcohol was higher than among women, as well as smokers. The self-assessment of health showed that 57% believed it to be very good or good, with lower proportion in the Northeast. The prevalence of chronic diseases/conditions, such as hypertension (38.6%), dyslipidemia (22.7%), arthritis/rheumatism (19.4%), depression (18.5%), diabetes (13.6%), and others are higher in these patients them among the general population. Medicines were predominantly sought in the health care service or in pharmacies of the Brazilian Unified Health System.

CONCLUSIONS

It was possible to characterize the profile of patients of Primary Health Care, but the originality of the research and its national scope hinders the comparison of results with official data or other articles.

Pharmaceutical Services, utilization; Patients; Health Profile; Socioeconomic Factors; Primary Health Care; Health Services Research; Unified Health System

Variable	North		Northeast		Midwest		Southeast		South		BRAZIL

	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Total number of respondents and weighted %
	1,625 5.9		1,675 29.7		1,525 5.9		1,837 34.0		2,014 24.5		8,676 100.0
No. of women interviewed
	1.225		1.351		1.134		1.416		1.517		6.643
	74.4	72.1–76.7	78.4	75.8–80.8	73.0	70.3–75.5	75.3	72.9–77.6	74.5	72.2–76.7	75.8	74.6–77.1
No. of men interviewed
	400		324		391		421		497		2.033
	25.6	23.3–27.9	21.6	19.2–24.2	27.0	24.5–29.7	24.7	22.4–27.1	25.5	23.3–27.8	24.2	22.9–25.4
Female sex per age group (years)
18 to 39	59.9	57.0–62.8	45.6	42.3–49.0	51.0	47.6–54.5	39.5	36.5–42.6	38.4	35.6–41.3	42.9	41.3–44.6
40 to 59	27.6	25.1–30.4	35.3	32.2–38.6	31.8	28.7–35.1	39.0	36.0–42.0	40.4	37.5–43.4	37.1	35.6–38.8
60 and +	12.4	10.6–14.5	19.1	16.6–21.9	17.1	14.7–19.9	21.5	19.0–24.2	21.2	18.9–23.7	19.9	18.6–21.3
Male sex per age group (years)
18 to 39	41.5	35.5–46.7	28.9	23.5–35.0	35.0	29.7–40.6	26.0	21.5–31.1	31.0	26.4–35.9	29.6	27.1–32.3
40 to 59	37.2	32.3–42.3	36.5	30.5–43.0	35.9	30.6–41.5	36.4	31.3–41.8	39.5	34.6–44.6	37.3	34.5–40.1
60 and +	21.3	17.4–25.9	34.5	28.7–40.9	29.2	24.3–34.6	37.6	32.4–43.1	29.5	25.1–34.3	33.1	30.4–36.0
Skin color
White	15.2	13.5–17.2	25.7	23.2–28.4	29.1	26.5–31.8	41.3	38.7–44.0	63.1	60.6–65.5	39.7	38.3–41.1
Black	8.8	7.4–10.4	7.8	6.4–9.5	9.2	7.7–11.0	9.2	7.7–10.8	5.4	4.4–6.7	7.8	7.1–8.6
Yellow	0.1	0.0–0.3	0.3	0.1–0.8	0.6	0.3–1.3	3.8	2.8–5.0	0.2	0.1–0.7	1.5	1.1–1.9
Mixed race	75.1	72.8–77.3	66.0	63.1–68.7	60.7	57.8–63.5	45.2	42.5–47.9	30.4	28.1–32.8	50.5	49.0–51.9
Indigenous	0.7	0.4–1.3	0.2	0.0–0.7	0.3	0.1–0.9	0.2	0.1–0.7	0.1	0.0–0.4	0.2	0.1–0.4
Marital status
Single	26.1	23.9–28.4	21.4	19.2–23.9	23.9	21.5–26.5	21.2	19.1–23.5	21.4	19.4–23.6	21.8	20.6–23.0
Married	39.0	36.5–41.5	45.7	42.8–48.7	49.0	46.1–51.9	52.0	49.3–54.7	49.8	47.3–52.4	48.6	47.2–50.1
Common–law marriage	26.4	24.1–28.7	21.3	19.0–23.8	15.1	13.1–17.3	12.1	10.4–14.0	12.8	11.2–14.6	16.0	15.0–17.1
Divorced/legally separated	4.0	3.1–5.1	5.3	4.1–6.7	6.7	5.4–8.3	7.8	6.4–9.3	7.6	6.4–9.1	6.7	6.0–7.5
Widower	4.5	3.5–5.7	6.2	4.9–7.8	5.1	3.9–6.5	6.8	5.5–8.2	8.2	6.9–9.7	6.7	6.0–7.5
Other	0.1	0.0–0.6	0.1	0.0–0.4	0.3	0.1–0.6	0.2	0.1–0.5	0.2	0.0–0.6	0.1	0.1–0.3

Variable	North		Northeast		Midwest		Southeast		South		BRAZIL

	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Education level per sex
Illiterate
F	7.9	6.4–9.7	12.5	10.4–14.9	5.8	4.4–7.7	7.2	5.7–9.0	11.2	9.4–13.2	9.7	8.8–10.8
M	13.6	10.4–17.6	18.1	13.6–23.5	7.4	4.9–11.1	8.5	5.8–12.1	11.0	8.1–14.6	11.9	10.1–14.0
Total	9.4	7.9–11.0	13.7	11.8–15.9	6.3	5.0–7.9	7.5	6.2–9.1	11.1	9.6–12.8	10.3	9.4–11.2
Elementary School
F	48.5	45.6–51.5	53.9	50.6–57.2	54.2	50.8–57.5	52.1	49.0–55.1	49.0	46.0–52.0	51.8	50.2–53.5
M	60.6	55.4–65.4	58.5	52.1–64.6	66.8	61.2–71.9	63.2	57.8–68.3	54.6	49.5–59.6	59.8	56.9–62.6
Total	51.6	49.0–54.2	54.9	52.0–57.8	57.6	54.6–60.4	54.8	52.1–57.5	50.4	47.9–53.0	53.7	52.3–55.2
High School
F	37.5	34.7–40.4	28.8	25.9–31.9	32.8	29.7–36.1	33.8	31.0–36.8	31.7	29.0–34.5	31.9	30.4–33.5
M	22.7	18.8–27.1	21.2	16.5–26.9	22.0	17.7–27.0	22.8	18.6–27.6	26.6	22.4–31.4	23.3	21.0–25.8
Total	33.7	31.4–36.2	27.2	24.6–29.9	29.9	27.3–32.6	31.1	28.7–33.6	30.4	28.1–32.8	29.9	28.6–31.2
Higher education
F	6.0	4.8–7.6	4.8	3.5–6.4	7.2	5.6–9.1	6.9	5.5–8.7	8.2	6.7–9.9	6.5	5.8–7.4
M	3.2	1.9–5.3	2.3	1.0–4.8	3.8	2.2–6.7	5.6	3.6–8.5	7.8	5.5–11.0	5.0	3.9–6.3
Total	5.3	4.3–6.5	4.2	3.2–5.5	6.3	5.0–7.8	6.6	5.4–8.0	8.1	6.8–9.6	6.2	5.5–6.9
ABEP
A+B	7.1	5.7–9.1	5.5	4.1–8.0	11.1	8.8–14.5	15.4	12.0–18.7	28.1	24.5–32.5	14.9	13.5–16.5
C	54.9	50.2–59.6	45.6	40.9–50.5	64.3	58.9–70.0	57.2	52.5–62.2	61.5	57.1–66.4	55.1	52.6–57.7
D+E	38.0	34.7–41.8	48.9	44.9–53.3	24.6	21.8–27.9	27.4	24.6–30.6	10.4	8.8–12.5	30.0	28.3–31.9
Government aid
Bolsa Família benefit	36.5	30.3–43.1	46.7	41.0–52.5	19.0	15.3–23.4	14.4	11.5–17.7	11.3	9.2–13.8	24.8	21.7–28.2
Unemployment insurance	0.6	0.3–1.2	0.1	0.0–0.6	0.6	0.2–2.0	0.3	0.1–0.6	0.9	0.5–1.8	0.4	0.3–0.7
Does not have	58.8	53.5–63.9	47.2	43.4–51.1	77.0	73.6–80.1	82.1	78.3–85.3	74.6	68.1–80.2	68.2	64.2–72.0
Other	4.0	2.3–7.0	5.8	2.2–14.5	3.4	2.0–5.7	3.2	1.8–5.7	13.2	8.4–20.0	6.5	4.5–9.3
Health insurance
Yes	2.5	1.9–3.3	8.5	6.0–12.1	6.2	5.0–7.6	9.6	8.0–11.5	16.7	14.7–18.8	9.8	8.9–10.7

Habits, lifestyle per sex	North		Northeast		Midwest		Southeast		South		BRAZIL

	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Alcoholic beverages consumption
Never
F	83.4	81.0–85.5	82.0	79.3–84.4	80.5	77.6–83.1	80.8	78.3–83.1	79.2	76.7–81.5	80.9	79.6–82.2
M	59.9	54.3–65.2	66.1	59.9–71.9	65.7	60.1–70.9	61.0	55.4–66.2	57.2	52.1–62.1	61.6	58.7–64.4
< once per month
F	10.4	8.7–12.4	11.6	9.6–13.9	10.8	8.8–13.2	10.1	8.4–12.1	11.1	9.4–13.1	10.9	9.9–11.9
M	16.2	12.6–20.6	13.9	10.0–19.0	13.6	10.1–18.0	18.5	14.5–23.2	11.9	9.0–15.6	15.1	13.1–17.3
≥ once per month
F	6.2	4.9–7.9	6.4	5.0–8.1	8.6	6.9–10.7	9.1	7.5–11.0	9.7	8.1–11.6	8.2	7.4–9.1
M	23.9	19.4–29.0	20.0	15.4–25.5	20.7	16.5–25.7	20.6	16.5–25.4	30.9	26.4–35.9	23.3	20.9–25.9
Currently smokes
Yes
F	6.2	4.8–7.9	8.3	6.6–10.3	10.3	8.3–12.0	12.0	10.1–14.2	15.5	13.5–17.7	11.3	10.3–12.4
M	19.4	15.4–24.3	17.0	12.7–22.4	18.7	14.6–23.5	20.1	16.0–25.0	22.5	18.5–27.1	19.8	17.5–22.2
Diets to lose weight
Yes
F	22.7	20.2–25.3	15.6	13.3–18.1	16.2	13.9–19.0	22.1	19.6–24.8	24.9	22.5–27.6	20.5	19.2–21.8
M	11.5	8.5–15.4	7.3	4.7–11.3	10.8	7.7–14.9	11.6	8.5–15.8	17.7	14.2–21.9	12.0	10.2–14.0
Avoids salt intake
Yes
F	66.7	63.7–69.5	58.4	55.1–61.7	56.1	52.7–59.5	58.1	55.0–61.1	67.7	64.8–70.4	60.9	59.2–62.5
M	54.7	49.1–60.2	53.4	47.0–59.7	49.4	43.7–55.2	49.5	44.0–55.0	60.3	55.2–65.2	53.7	50.7–56.6
Reduces fat intake
Yes
F	58.4	55.4–61.4	57.1	53.0–60.4	53.7	50.2–57.1	53.3	50.1–56.4	65.4	62.6–68.2	57.7	56.1–59.3
M	48.9	43.3–54.4	46.6	40.3–53.0	37.2	31.9–42.9	41.6	36.3–47.2	49.3	44.2–54.4	45.1	42.2–48.0
Reduces sugar intake
Yes
F	50.6	47.6–53.7	44.1	40.8–47.4	42.0	38.7–45.5	43.4	40.4–46.5	52.8	49.8–55.7	46.2	44.6–47.9
M	41.9	36.5–47.5	33.9	28.2–40.1	33.0	27.9–38.6	35.7	30.5–41.1	42.3	37.4–47.4	37.1	34.3–40.0
Uses sweetener
Yes
F	17.8	15.6–20.2	20.6	18.0–23.4	12.1	10.0–14.5	22.4	19.9–25.1	21.6	19.3–24.1	20.8	19.5–22.2
M	16.1	12.5–20.6	22.8	17.9–28.6	9.9	7.0–13.8	19.5	15.4–24.2	19.0	15.3–23.2	19.4	17.2–21.9
Performed physical exercises in the past 3 months
Yes
F	22.1	19.4–25.0	18.9	16.6–21.3	20.5	18.0–23.4	21.7	19.3–24.2	38.6	35.7–41.5	25.3	23.9–26.8
M	24.0	19.6–29.0	22.9	18.0–28.6	26.5	21.8–31.9	20.5	16.4–25.2	46.4	41.3–51.5	28.5	26.0–31.2

Health condition	North		Northeast		Midwest		Southeast		South		Brazil

	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Health self–assessment
Very good and good	59.7	55.9–63.8	47.5	43.5–51.9	58.6	53.0–63.7	62.1	57.7–66.8	60.4	56.4–64.5	57.0	54.7–59.3
Neither bad nor good	32.3	29.8–34.8	42.1	39.2–45.1	34.2	31.4–37.0	32.1	29.7–34.7	31.0	28.7–33.5	35.0	33.6–36.4
Very bad and bad	7.9	6.3–10.1	10.2	8.0–12.8	7.2	5.3–9.6	5.6	4.2–7.5	8.5	6.7–10.8	7.9	7.0–9.0
Chronic disease/condition diagnosed by a doctor or other health professional
Hypertension	25.6	23.3–28.0	37.0	34.2–39.9	32.4	29.7–35.2	41.6	38.9–44.3	40.6	38.1–43.1	38.6	37.1–40.0
Dyslipidemia	19.2	17.2–21.3	22.8	20.4–25.4	18.6	16.4–21.0	21.6	19.5–24.0	25.7	23.6–28.0	22.7	21.5–23.9
Arthritis/Rheumatism	14.0	12.3–16.0	16.7	14.7–19.0	18.9	16.7–21.4	30.9	27.8–34.2	26.4	24.2–28.8	19.4	18.3–20.6
Depression	8.5	7.1–10.0	15.2	13.2–17.5	13.0	11.2–15.1	16.8	14.9–18.9	28.3	23.6–30.7	18.5	17.4–19.6
Diabetes	9.9	8.5–11.7	11.6	9.8–13.6	10.3	8.6–12.2	15.8	13.9–17.9	14.6	12.9–16.4	13.6	12.6–14.6
Chronic Lung Disease	8.4	7.1–10.0	7.3	5.9–8.9	8.6	7.1–10.4	8.8	7.4–10.5	13.9	12.2–15.7	9.6	8.8–10.4
Heart disease	3.5	2.6–4.6	5.7	4.5–7.2	6.5	5.2–8.1	7.8	6.4–9.4	11.1	9.6–12.8	7.7	6.9–8.5
Cerebrovascular accident	1.5	1.0–2.2	3.3	2.4–4.5	1.1	0.6–1.8	1.3	0.8–2.1	3.6	2.7–4.6	2.5	2.1–3.0

Search for service and medicines	North		Northeast		Midwest		Southeast		South		Brazil

	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Search for care at PHCU
Always	67.0	64.4–69.4	75.6	73.0–78.1	60.4	37.5–63.3	73.5	71.0–75.8	73.4	71.0–75.6	73.0	71.7–74.2
Repeatedly	4.6	3.6–5.9	3.1	2.2–4.3	6.3	4.9–7.9	5.2	4.2–6.6	1.8	1.2–2.6	3.8	3.3–4.4
Sometimes	19.2	17.1–21.4	13.0	11.1–15.1	19.4	17.1–21.8	11.9	10.2–13.7	16.5	14.7–18.6	14.2	13.2–15.2
Rarely	6.0	4.8–7.3	5.2	4.0–6.7	10.6	8.9–12.6	7.1	5.8–8.6	5.2	4.1–6.5	6.2	5.5–6.9
Never	0.0	0.0–0.3	0.0	0.0–0.1	0.2	0.1–0.7	0.4	0.2–0.9	0.1	0.0–0.5	0.2	0.1–0.4
First time	3.2	2.4–4.4	3.0	2.2–4.2	3.1	2.3–4.3	1.9	1.4–2.8	3.0	2.3–4.0	2.7	2.3–3.2
Used emergency services in the past year
Yes	21.0	19.0–23.3	22.3	20.0–24.9	26.1	23.3–28.8	18.3	16.3–20.5	29.5	27.2–31.9	22.9	21.7–24.1
Hospitalization in the past 12 months
Yes	8.8	7.4–10.5	9.4	7.8–11.3	12.5	10.0–14.6	7.6	6.3–9.1	12.1	10.5–13.9	9.6	8.8–10.5
Took medicine in the past month
Yes	64.5	62.0–67.0	73.7	71.1–76.2	70.7	68.0–73.3	74.5	72.1–76.8	83.4	81.4–85.2	75.6	74.4–76.9
Sought medicines in SUS pharmacies in the past 3 months?
Only in UBS	44.9	42.3–47.6	38.3	35.4–41.2	33.7	31.1–36.6	43.2	40.5–45.9	50.1	47.5–52.6	43.0	41.5–44.4
Only in other SUS Pharmacies	4.2	3.3–5.4	4.5	3.4–6.0	9.6	8.0–11.4	5.5	4.4–6.9	6.7	5.5–8.1	5.7	5.1–6.4
In both	18.4	16.4–20.6	16.7	14.6–19.0	21.4	19.0–23.9	19.8	17.7–22.1	16.6	14.8–18.6	18.1	17.0–19.2
Did not seek	16.0	14.2–18.0	6.5	5.2–8.1	9.6	8.1–11.3	12.8	11.1–14.8	15.5	13.7–17.5	11.6	10.7–12.5
Did not use any SUS pharmacy	16.5	14.5–18.6	33.0	30.9–36.5	25.6	23.1–28.3	18.1	16.1–20.2	11.1	9.6–12.8	21.4	20.2–22.6

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

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