Coverage by the public health services of medication and vaccines for the population with diabetes mellitus

Monteiro, Camila Nascimento; Gianini, Reinaldo José; Goldbaum, Moisés; Cesar, Chester Luiz Galvão; Barros, Marilisa Berti Azevedo

doi:10.1590/1413-81232015202.02112014

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FREE THEMES • Ciênc. saúde coletiva 20 (2) • Feb 2015 • https://doi.org/10.1590/1413-81232015202.02112014 copy

Coverage by the public health services of medication and vaccines for the population with diabetes mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

This study analyzed the coverage by the public health service of expenses with medication and vaccines for the adult population of São Paulo with self-reported diabetes mellitus in 2003 and the implications for access to medicines and vaccination campaigns programs. Data were collected by the Multicenter Health Survey of São Paulo. The Unified Health System (SUS) was widely used by the population for vaccination against influenza and pneumonia and there was significant private sector participation for coverage of expenses with medication, with an estimated coverage of 38% by SUS. There were no significant differences in the prevalence of use of public services for vaccination among the categories of variables studied, suggesting a universal distribution of vaccination by the public health service. Unlike vaccinations, in 2003 the coverage of medication expenses by the public health service was recent in Brazil, which may explain the low level of coverage. An analysis of coverage of vaccination and medication expenses in diabetes mellitus population since 2003 may contribute to be the basis for policies to broaden access of the population to health services.

Diabetes mellitus; Health service coverage; National medication policy; National policy of pharmaceutical assistance; Immunization programs

Variables, categories and n^* * Number of interviewees who were vaccinated against the flu and/or pneumonia (n = 107).	Prevalence of USPV^ In all, 89 interviewees (74%) had been vaccinated against influenza and/or pneumonia using the public health system.	IC95%	PR	IC95% for PR	Value of p
Sex					0,976
Male (n=48)	75.1%	45.8 – 91.4	1
Female (n=59)	74.6%	49.6 – 89.7	0.9	0.6 – 1.5
Race/Ethnicity					0.894
Caucasian (n = 68)	75.4%	52.2 – 89.6	1
Non Caucasian (n = 39)	73.6%	48.6 – 89.2	0.9	0.7 – 1.4
Marital status^* ***** Don't know/No answer responses excluded					0.316
With partner (n = 56)	69.1%	43.3 – 86.8	1
No partner (n = 51)	82.5%	67.0 – 91.6	1.1	0.8 – 1.7
Years of Schooling^* ***** Don't know/No answer responses excluded					0.203
None or fewer than 3 years (n = 51)	89.3%	75.2 – 95.8	1
4 to 7 (n = 40)	73.2%	42.9 – 90.8	0.8	0.6 – 1.2
8 or more years (n = 15)	56.7%	20.1 – 87.2	0.6	0.3 – 1.3
Paid work^* ***** Don't know/No answer responses excluded					0.887
EAP (n=22)	76.2%	50.7 – 90.8	1
Not part of the EAP (n = 85)	74.4%	53.4 – 88.0	0.9	0.7 – 1.4
Per capita income					0.171
≥ 1 mw (n = 42)	76.8%	52.7 – 90.7	1
1-2 mw (n = 40)	88.8%	71.5 – 96.1	1.1	0.8 – 1.5
≥ 2 mw (n = 25)	59.6%	26.4 – 85.8	0.7	0.4 – 1.4
Health self-assessment^* ***** Don't know/No answer responses excluded					0.594
Excellent, very good or good (n = 84)	76.3%	55.6 – 89.2	1
Poor or very poor (n = 22)	69.1%	40.5 – 87.9	0.9	0.6 – 1.3

Variables, categories and n^* * Number of interviewees using medicines in the three days prior to the interview (n = 155).	Prevalence of SUS coverage^ The prevalence of SUS coverage for the cost of medicines was 38% (n = 68).	IC95%	PR	IC95% da RP	Value of p
Gender					0.308
Male (n = 67)	37.4%	20.5 – 58.0	1
Female (n = 88)	38.4%	26.8 – 51.5	1.02	0.5 – 1.9
Race/Ethnicity					0.026
Caucasian (n = 108)	31.1%	22.5 – 41.1	1
Non Caucasian (n = 47)	52.0%	30.1 – 73.2	1.7	1.1 – 2.7
Marital status^ The prevalence of SUS coverage for the cost of medicines was 38% (n = 68).					0.047
With partner (n = 79)	27.4%	15.7 – 43.3	1
No partner (n = 74)	51.9%	36.1 – 67.3	1.9	1.1 – 3.5
Years of Schooling^ The prevalence of SUS coverage for the cost of medicines was 38% (n = 68).					0.151
None or fewer than 3 years (n = 66)	52.5%	34.6 – 69.9	1
4 to 7 (n = 57)	38.2%	23.8 – 55.1	0.7	0.4 – 1.3
8 or more years (n = 29)	25.5%	10.5 – 49.9	0.5	0.2 – 1.2
Paid work^ The prevalence of SUS coverage for the cost of medicines was 38% (n = 68).					0.038
EAP (n=35)	16.6%	5.8 – 39.3	1
Not part of the EAP (n = 117)	49.1%	35.9 – 62.5	3	1.1 – 8.2
Per capita income					0.372
≥ 1 mw (n = 65)	51.7%	33.7 – 69.3	1
1-2 mw (n = 44)	35.1%	21.4 – 51.9	0.7	0.4 – 1.2
≥ 2 mw (n = 46)	26.2%	5.1 – 46.0	0.5	0.2 – 1.5
Health self-assessment^ The prevalence of SUS coverage for the cost of medicines was 38% (n = 68).					0.043
Excellent, very good or good (n = 114)	31.3%	20.5 – 44.7	1
Poor or very poor (n = 40)	55.1%	24.4 – 82.3	1.7	1.1 – 3.0

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[1] Collaborations CN Monteiro, RJ Gianini, M Goldbaum, CLG Cesar and MBA Barros participated equally in all stages of preparation of the article.