Use of health services among adults living in Manaus Metropolitan Region, Brazil: population-based survey, 2015*

Silva, Marcus Tolentino; Galvão, Taís Freire

doi:10.5123/S1679-49742017000400005

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Epidemiologia e Serviços de Saúde

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Original article • Epidemiol. Serv. Saúde 26 (04) • Oct-Dec 2017 • https://doi.org/10.5123/S1679-49742017000400005 copy

Use of health services among adults living in Manaus Metropolitan Region, Brazil: population-based survey, 2015^* * This research was funded by the National Council for Scientific and Technological Development (CNPq): Process No. 404990/2013-4 and 448093/2014-6. Resources were provided by the Federal Government, through the Ministry of Health and the Ministry of Science, Technology and Innovation.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE:

to describe the use of health services in adults living in Manaus Metropolitan Region, Amazonas, Brazil.

METHODS:

a population-based cross-sectional study was carried out with adults (≥18 years) living in Manaus Metropolitan Region in 2015; probabilistic sampling with three-stage clusters was used; data were collected at the participants’ households.

RESULTS:

4,001 adults participated, 52.8% were women, 49.7% aged 18-34 years; 80% rated their health status as good/regular; in the fortnight previous to the survey, 20.9% (95%CI 19.7;22.2%) had used a health service, 44.4% of those visited a primary health care unit; 2.9% (95%CI 2.4;3.4%) never used a health service; among those who already visited a doctor (n=3,886), most gave positive feedback about the last visit.

CONCLUSION:

health situation and last medical visit were positively assessed; one fifth of the population had used a health service in the two weeks prior to the interview, primary health care units were the main services used.

Keywords:
Health Services; Diagnosis of Health Situation; Population; Surveys and Questionnaires; Epidemiology, Descriptive

Participants’ characteristics	n	%	Adjusted%^a	95%CI^b
Sex
Male	1,888	47.2	47.2	45.7-48.8
Female	2,113	52.8	52.8	51.2-54.3
Age (in years)
18-24	838	20.9	20.9	19.6-22.1
25-34	1,152	28.8	28.8	27.4-30.2
35-44	843	21.1	21.1	19.9-22.4
45-59	772	19.3	19.3	18.1-20.6
≥60	396	9.9	9.9	9.0;10.9
Ethnicity/skin color
White	636	15.9	15.9	14.8-17.1
Black	300	7.5	7.5	6.7-8.3
Asian	138	3.5	3.5	2.9-4.1
Brown	2,886	72.1	72.2	70.7-73.5
Indigenous	41	1.0	1.0	0.8-1.4
Marital status
Married	1,409	35.2	35.2	33.8-36.7
Separated	157	3.9	3.9	3.4-4.6
Divorced	103	2.6	2.6	2.1-3.1
Widowed	159	4.0	4.0	3.4-4.6
Single	2,173	54.3	54.3	52.7-55.8
Education level
Higher education degree or above	158	4.0	4.0	3.4-4.6
High school	1,903	47.6	47.5	46.0-49.1
Complete Elementary school	649	16.2	16.2	15.1-17.4
Incomplete Elementary school or less	1,291	32.3	32.3	30.8-33.7
Municipality
Manaus	3,479	87.0	86.7	85.8-87.9
Careiro da Várzea	41	1.0	1.1	0.7-1.5
Iranduba	70	1.8	1.7	1.4-2.1
Itacoatiara	154	3.9	3.8	3.2-4.4
Manacapuru	140	3.5	3.5	3.0-4.1
Novo Airão	20	0.5	0.6	0.4-1.0
Presidente Figueiredo	57	1.4	1.3	1.0-1.7
Rio Preto da Eva	40	1.0	1.2	0.8-1.6
Economic class
A	34	0.9	0.9	0.6-1.2
B1	90	2.3	2.2	1.8-2.8
B2	505	12.6	12.6	11.6-13.7
C1	862	21.5	21.5	20.3-22.8
C2	1,423	35.6	35.6	34.1-37.1
D/E	1,087	27.2	27.1	25.8-28.5
Health status
Very good	471	11.8	11.9	10.9-12.9
Good	2,175	54.7	54.3	52.7-55.8
Regular	1,108	27.7	27.7	26.3-29.1
Bad	193	4.8	4.9	4.2-5.6
Very bad	54	1.4	1.4	1.0-1.8

Variables	n	%	Adjusted% ^a	95%CI^b
Main reason
Health problem	541	64.6	64.5	61.2-67.7
Diagnosis/prevention	184	22.0	22.0	19.3-25.0
Prenatal/childbirth	37	4.4	4.4	3.2-6.0
Other	76	9.1	9.1	7.3-11.2
Type of service
Medical visit	642	76.6	76.5	73.5-79.3
Dental visit	72	8.6	8.6	6.9-10.7
Therapeutic/diagnostic procedure	85	10.1	10.2	8.3-12.5
Other	39	4.7	4.7	3.4-6.3
Assistance at first attempt
Yes	707	84.4	84.4	81.7-86.7
No	131	15.6	15.6	13.2-18.3
Number of attempts for health service
1	648	77.3	77.3	74.3-80.0
2 or more	190	22.7	22.7	20.0-25.7
Place of assistance ^c
Primary health care unit	372	44.4	44.4	41.1-47.8
Outpatient clinic	238	28.4	28.4	25.4-31.5
Urgency/emergency	344	41.1	41.1	37.8-44.4
Other	20	2.4	2.4	1.5-3.7

Variables	n	%	Adjusted% ^a	95%CI^b
Last medical visit
In the last 12 months	3,066	76.6	76.6	75.2-77.8
From 1 to less than 2 years ago	531	13.3	13.3	12.3-14.4
2 or more years ago	489	12.2	12.2	6.5-8.1
Never went to the doctor	115	2.9	2.9	2.4-3.4
Type of doctor
Family doctor or general practitioner	2,995	74.9	74.9	73.5-76.2
Gynecologist	402	10.1	10.0	9.1-11.0
Other specialist	489	12.2	12.2	11.2-13.3
Never went to the doctor	115	2.9	2.9	2.4-3.4

Assessment	Good % ^a	Regular % ^a	Bad % ^a
Equipment availability	61.8	26.2	12.0
Room for consultation	61.1	27.5	11.4
Travel time	51.8	29.2	18.9
Waiting time	44.4	28.3	27.3
Attendants	60.9	25.5	13.6
Cleanliness	55.9	28.0	16.1
Physician’s skills	64.3	23.6	12.1
Physician’s respect	66.0	22.9	11.0
Physician’s transparency	63.6	23.9	12.5
Privacy with the physician	68.0	21.5	10.4
Availability for questions	65.4	22.2	12.3
Freedom in choosing a physician	45.8	28.6	25.7

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Marcus Tolentino Silva - Universidade Federal do Amazonas, Faculdade de Medicina. Rua Afonso Pena, No. 1053, Manaus-AM, Brasil. CEP: 69020-160. E-mail: marcusts@gmail.com