Characteristics of women who do not consult a doctor: a population-based study

Dias-da-Costa, Juvenal Soares; Koltermann, Annie Pozeczek; Cappellesso, Bruna; Lisowski, Josiele Flores; Bernardelli, Maiton; Xavier, Paula Brustolin; Donatti, Talita; Morimoto, Tissiani; Bairros, Fernanda Souza de; Olinto, Maria Teresa Anselmo

doi:10.11606/S1518-8787.2018052000190

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Sumário

Original Article • Rev. Saúde Pública 52 • 2018 • https://doi.org/10.11606/S1518-8787.2018052000190 copy

Characteristics of women who do not consult a doctor: a population-based study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To analyze the prevalence of not consulting a doctor within a year.

METHODS

Cross-sectional population-based study, including women aged 20–60 years, living in the urban area of São Leopoldo, state of Rio Grande do Sul, in 2015. The association between variables and outcome was assessed using prevalence ratios and 95% confidence intervals (95%CI). The adjusted analysis was performed using Poisson regression with robust variance.

RESULTS

Among the 1,127 women participating in the study, 954 (84.6%, 95%CI 82.5–86.7) reported having consulted a physician in the year prior to the interview, 173 (15.4%, 95%CI 13.2–17.5) did not. Women belonging to lower income classes D and E, younger, and smokers had higher prevalences of no medical visits. The participants with hypertension had a higher prevalence of consultations.

CONCLUSIONS

There was no expected evolution in the local health system, despite the emergence of the policies implemented in this period. It is necessary to provide care for those in less favored socioeconomic conditions and for younger women.

DESCRIPTORS
Women; Patient Acceptance of Health Care; Health Services, utilization; Primary Health Care; Health Services Accessibility; Ambulatory Care

Variable		n	%	Prevalence of non-use (%)	PR	95%CI	p
Age (years)							< 0.001
	20–29	216	19.2	51 (29.3)	1
	30–39	244	21.7	44 (25.3)	0.76	0.53–1.09
	40–49	276	24.5	41 (23.6)	0.63	0.43–0.91
	50–59	228	20.2	23 (13.2)	0.43	0.27–0.67
	60–69	163	14.5	15 (8.6)	0.39	0.23–0.67
Color							0.78
	Non-white	288	25.6	46 (16.0)	1
	White	839	74.4	128 (15.3)	0.95	0.69–1.29
Marital status							0.44
	Single	227	20.1	43 (18.9)	1
	Married/In a union	720	63.9	105 (14.6)	0.79	0.57–1.09
	Separated/Divorced	110	9.8	16 (14.5)	0.78	0.46–1.33
	Widow	70	6.2	10 (14.3)	0.76	0.40–1.43
Education (years)							< 0.01
	≥ 15	110	9.8	6 (5.5)	1
	11–14	360	32.0	62 (17.2)	3.16	1.40–7.10
	8–10	198	17.6	40 (20.2)	3.61	1.58–8.26
	5–7	253	22.5	42 (16.6)	3.04	1.33–6.95
	0–4	204	18.1	24 (11.8)	2.16	0.91–5.12
Economic class
	A	44	3.9	2 (4.5)	1		< 0.001
	B	346	30.9	37 (10.7)	2.35	0.59–9.43
	C	595	53.1	101 (17.1)	3.73	0.95–14.64
	D+E	136	12.1	33 (24.3)	5.34	1.34–21.36
Income per capita in minimum wages (MW)							< 0.001
	3 or more	66	6.1	7 (10.6)	1
	1 a 2.99	361	33.1	32 (8.9)	0.83	0.38–1.81
	Less than 1	663	60.8	127 (19.3)	1.81	0.88–3.71

Variable		n	%	Prevalence of non-use (%)	PR	95%CI	p
Smoking							0.001
	Does not smoke	661	59.0	90 (13.6)	1
	Former smoker	253	22.6	32 (12.6)	0.93	0.64–1.35
	Smoker	207	18.5	207 (24.6)	1.81	1.33–2.46
Excessive consumption of alcohol							0.17
	No	1,086	97.0	166 (15.3)	1
	Yes	34	3.0	8 (23.5)	1.54	0.83–2.87
Physical activity							0.25
	Yes	162	14.4	20 (12.3)	1
	No	965	85.6	154 (16.0)	1.29	0.84–2.00
Overweight							0.001
	No	380	33.9	78 (20.5)	1
	Yes	741	66.1	95 (12.8)	0.62	0.47–0.82
High blood pressure							< 0.001
	No	810	71.9	153 (18.9)	1
	Yes	316	28.1	21 (6.6)	0.35	0.16–0.22
Diabetes Mellitus							< 0.01
	No	1,029	91.9	167 (16.2)	1
	Yes	91	8.1	5 (5.5)	0.34	0.14–0.19
Psychiatric disorders							0.65
	No	678	60.2	102 (15.0)	1
	Yes	449	39.8	72 (16.0)	1.06	0.81–1.40

Variable		Adjusted PR	95%CI	p
Age group (years)^a a Variables adjusted to each other.				< 0.001
	20–29	1
	30–39	0.76	0.53–1.09
	40–49	0.68	0.47–0.98
	50–59	0.42	0.26–0.68
	60–69	0.42	0.25–0.72
Economic class^a a Variables adjusted to each other.				< 0.05
	A	1
	B	4.2	0.61–28.5
	C	5.76	0.84–39.5
	D+E	7.20	1.03–50.3
Income per capita in minimum wages (MW)^a a Variables adjusted to each other.				0.02
	3 or more	1
	1 a 2.99	0.59	0.28–1.25
	Less than 1	1.00	0.47–2.11
Smoking^b b Adjusted for age group, economic class, per capita income in minimum wages, and to each other.				0.02
	Does not smoke	1
	Former smoker	0.95	0.64–1.41
	Smoker	1.53	1.10–2.13
Excessive consumption of alcohol^b b Adjusted for age group, economic class, per capita income in minimum wages, and to each other.				0.79
	No	1
	Yes	1.10	0.55–2.20
Overweight^c c Adjusted for age group, economic class, per capita income in minimum salaries, smoking, and to each other.				0.06
	No	1
	Yes	0.76	0.57–1.01
High blood pressure^c c Adjusted for age group, economic class, per capita income in minimum salaries, smoking, and to each other.				< 0.001
	No	1
	Yes	0.40	0.24–0.66
Diabetes mellitus^c c Adjusted for age group, economic class, per capita income in minimum salaries, smoking, and to each other.				0.25
	No	1
	Yes	0.63	0.25–1.57

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[1] Correspondence: Juvenal Soares Dias da Costa, Avenida Unisinos, 950 93022-000 São Leopoldo, RS, Brasil, E-mail: episoares@terra.com.br