Analysis of access to health services in Brazil according to sociodemographic profile: National Health Survey, 2019

Palmeira, Nathalia Campos; Moro, Julia Pustrelo; Getulino, Fabiana de Abreu; Vieira, Yohana Pereira; Soares Junior, Abelardo de Oliveira; Saes, Mirelle de Oliveira

Nathalia Campos Palmeira Correspondence: Nathalia Campos Palmeira | nathalia_camposp@hotmail.com

collaborated with the study conception and design

analysis and interpretation of the results

drafting and critical reviewing of the manuscript content

final version and declared

including ensuring its accuracy and integrity

Universidade Federal do Rio Grande, Faculdade de Medicina, Rio Grande, RS, Brazil

http://orcid.org/0000-0001-8173-9429

Julia Pustrelo Moro

collaborated with the study conception and design

data analysis and interpretation and critical reviewing of the manuscript content

final version and declared

including ensuring its accuracy and integrity

Universidade Federal do Rio Grande, Faculdade de Medicina, Rio Grande, RS, Brazil

http://orcid.org/0000-0001-5450-8297

Fabiana de Abreu Getulino

collaborated with the study conception and design

data analysis and interpretation and critical reviewing of the manuscript content

final version and declared

including ensuring its accuracy and integrity

Universidade Federal do Rio Grande, Faculdade de Medicina, Rio Grande, RS, Brazil

http://orcid.org/0000-0002-0999-7551

Yohana Pereira Vieira

collaborated with the study analysis

conception and design

drafting and critical reviewing of the manuscript content

final version and declared

including ensuring its accuracy and integrity

Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brazil

http://orcid.org/0000-0003-4828-8210

Abelardo de Oliveira Soares Junior

collaborated with the study analysis

conception and design

drafting and critical reviewing of the manuscript content

final version and declared

including ensuring its accuracy and integrity

Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brazil

http://orcid.org/0000-0003-4682-688X

Mirelle de Oliveira Saes

collaborated with the study analysis

conception and design

drafting and critical reviewing of the manuscript content

final version and declared

including ensuring its accuracy and integrity

Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brazil

http://orcid.org/0000-0001-7225-1552

Correspondence: Nathalia Campos Palmeira | nathalia_camposp@hotmail.com

CONFLICTS OF INTEREST

The authors declare they have no conflicts of interest.

Associate editor: Bárbara Reis-Santos orcid.org/0000-0001-6952-0352

Study contributions
Main results	The use of dental services and health care visits aimed at seeking medicines, either through public services or through the Brazilian Popular Pharmacy Program, was more frequent for people living in the North and Northeast regions, and among individuals with low level of education.
Implications for services	To help health managers to guide health policies, according to the needs of each region, in addition to providing access and availability, and also make the services offered by the Brazilian National Health System more effective.
Perspectives	It is expected that health indicators of the Brazilian population will present a reduction in the iniquity in access to and use of health services.

Variable	n	Sex
		Female		Male
		%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI
Stopped performing usual activities for health reasons^b b) In the two weeks prior to the survey;	279,382	11.6	10.7;11.7	6.6	6.2;7.0
Sought medical care from the same medical professional or sought for the same health service	279,382	77.5	76.7;78.3	75.5	74.6;76.3
Had a doctor's appointment in the last 12 months	206,384	80.6	80.4;80.8	66.6	66.3;66.8
Had a dentist appointment in the last 12 months	279,382	52.8	51.9;53.7	45.2	44.3;46.2
Sought medical care in health services^b b) In the two weeks prior to the survey;	279,382	26.5	25.8;27.3	17.6	17.1;18.4
Got medical care the first time they sought it^b b) In the two weeks prior to the survey;	6,615	29.4	27.7;31.1	29.8	27.6;32.0
Got medical care and prescriptions filled^b b) In the two weeks prior to the survey;	40,357	59.8	58.0;61.6	58.9	56.6;61.2
Obtained all prescribed medicines (by some means)^c c) In the last health care visit;	24,753	83.6	81.7;85.3	86.1	83.8;88.1
Obtained at least one of the medicines prescribed in the last health care visit^c c) In the last health care visit;	24,753	8.4	7.1;9.9	6.9	5.5;8.6
Obtained at least one of the medicines prescribed through the Brazilian Popular Pharmacy Program in the last health care visit^c c) In the last health care visit;	22,548	11.4	10.0;13.0	11.8	9.9;14.0
Obtained at least one medicine through the public service, in the last health care visit^c c) In the last health care visit;	20,501	19.4	17.4;21.6	19.3	16.9;22.0
Have been hospitalized for 24 hours^d d) In the 12 months prior to the survey.	279,382	8.8	8.4;9.3	6.1	5.7;6.6
Last hospitalization occurred in a unit within the Brazilian National Health System	17,392	64.3	60.9;67.2	61.9	58.2;65.3

Variable	n	Age groups (in years)
		0 to 17		18 to 29		30 to 39		40 to 59		60 years and older
		%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;
Stopped performing usual activities for health reasons^b b) In the two weeks prior to the survey;	279,382	5.2	3.5;7.8	5.4	4.7;6.0	7.2	6.5;7.9	9.0	8.2;9.9	12.0	11.4;12.8
Sought medical care from the same medical professional or sought for the same health service	279,382	78.3	75.7;80.7	74.8	73.5;76.0	75.9	74.7;77.0	76.2	75.3;77.2	78.8	77.8;79.7
Had a doctor's appointment in the last 12 months	206,384	66.6	63.1;69.8	69.9	69.5;70.4	77.3	76.2;78.4	78.0	77.6;78.5	85.0	84.7;85.3
Had a dentist appointment in the last 12 months	279,382	59.3	55.7;62.9	55.1	53.6;56.6	56.1	54.8;57.3	50.8	49.6;51.7	35.2	33.9;36.5
Sought medical care in health services^b b) In the two weeks prior to the survey;	279,382	13.4	10.1;16.7	15.8	14.9;16.9	19.0	17.9;20.1	23.7	22.8;24.7	29.4	28.3;30.4
Got medical care the first time they sought it^b b) In the two weeks prior to the survey;	6,615	80.7	71.3;87.5	67.1	63.5;70.6	71.1	68.2;73.8	66.0	63.7;68.2	68.1	66.0;70.3
Got medical care and prescriptions filled^b b) In the two weeks prior to the survey;	40,357	59.7	46.8;71.5	58.2	54.1;62.3	58.0	54.5;61.3	60.0	57.5;62.6	60.0	57.6;62.4
Obtained all prescribed medicines (by some means)^c c) In the last health care visit;	24,753	71.9	47.3; 87.9	86.9	83.5;89.6	83.7	79.3;87.3	84.2	82.2;86.0	85.5	83.1;87.5
Obtained at least one of the prescribed medicines^c c) In the last health care visit;	24,753	9.3	2.5;29.2	7.1	5.2;9.6	9.1	4.9;10.1	8.1	6.8;9.8	6.5	5.2;8.2
Obtained at least one of the medicines prescribed through the Brazilian Popular Pharmacy Program^c c) In the last health care visit;	22,548	4.6	0.9;19.2	5.6	3.4;9.2	6.3	4.3;9.0	11.0	9.2;13.2	17.7	15.4;20.4
Obtained at least one medicine through the public service^c c) In the last health care visit;	20,501	10.5	4.1;24.3	16.6	12.2;22.1	15.2	11.6;19.7	17.8	15.5;20.3	25.2	22.1;28.4
Have been hospitalized for 24 hours^d d) In the 12 months prior to the survey. 12 months prior to the survey.	279,382	4.7	3.1;7.0	6.0	5.4;6.7	7.3	6.6;8.0	7.0	6.5;7.5	10.4	9.8;11.1
Last hospitalization occurred in a unit within the Brazilian National Health System	17,392	82.1	63.5;92.4	68.4	61.7;73.6	56.3	50.4;62.0	62.5	58.5; 66.4	65.0	61.7;68.2

Variable	n	Macro-regions
		North		Northeast		Midwest		Southeast		South
		%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;
Stopped performing usual activities for health reasons^b b) In the two weeks prior to the survey;	279,382	9.0	8.4;9.7	9.6	9.1;10.2	8.7	7.9;9.6	9.0	8.4;9.6	8.1	7.4;8.8
Sought medical care from the same medical professional or sought for the same health service	279,382	70.5	67.9;71.0	76.0	74.9;77.0	71.0	69.0;72.3	78.8	77.7;80.0	77.3	75.7;78.8
Had a doctor's appointment in the last 12 months	206,384	69.1	68.8;70.0	71.6	71.3;71.8	74.4	73.9;74.9	80.5	80.2;80.8	78.0	77.6;78.5
Had a dentist appointment in the last 12 months	279,382	41.3	39.9;42.8	42.4	41.4;43.4	48.4	46.8;50.1	53.0	51.8;54.3	54.0	52.5;55.5
Sought medical care in health services^b b) In the two weeks prior to the survey;	279,382	16.6	15.7;17.6	19.5	18.8;20.3	19.7	18.5;20.9	25.1	24.1;26.2	23.5	22.4;24.6
Got medical care the first time they sought it^b b) In the two weeks prior to the survey;	6,615	63.2	60.0;66.3	72.7	70.1;74.5	70.5	67.5;73.3	68.5	66.0;70.9	59.9	56.9;62.7
Got medical care and prescriptions filled^b b) In the two weeks prior to the survey;	40,357	62.2	58.9;65.4	57.6	55.4;59.7	61.8	58.4;65.0	59.2	56.6;61.9	61.1	57.9;64.3
Obtained all prescribed medicines (by some means)^c c) In the last health care visit;	24,753	81.5	78.4;84.3	83.7	81.4;85.7	85.1	82.0;87.7	84.5	82.3;87.3	85.3	82.3;87.9
Obtained at least one of the prescribed medicines^c c) In the last health care visit;	24,753	8.9	7.1;11.1	8.0	6.5;9.9	5.7	4.2;7.6	8.0	6.3;10.0	7.8	6.1;9.9
Obtained at least one of the medicines prescribed through the Brazilian Popular Pharmacy Program^c c) In the last health care visit;	22,548	8.7	6.6;11.5	7.8	6.5;9.4	12.1	9.4;15.4	11.5	9.5;13.8	17.8	15.1;21.0
Obtained at least one medicine through the public service^c c) In the last health care visit;	20,501	19.4	16.0;23.3	17.5	15.2;20.2	15.2	12.3;18.7	20.3	17.3;23.7	18.9	15.9;22.3
Have been hospitalized for 24 hours^d d) In the 12 months prior to the survey.	279,382	6.6	6.0;7.2	6.7	6.2;7.1	9.2	8.5;10.1	7.9	7.2;8.5	8.1	7.4;8.8
Last hospitalization occurred in a unit within the Brazilian National Health System	17,392	73.1	68.3;77.4	77.1	73.9;80.0	60.8	56.1;65.4	55.6	50.8;60.4	63.1	58.6;67.4

Variable	n	Level of education
		Without schooling		Incomplete elementary education		Complete elementary education/Incomplete high school		Complete high school/Incomplete higher education		Complete higher education
		%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;	%	95%CI^a a) 95%CI: 95% confidence interval;
Stopped performing usual activities for health reasons^b b) In the two weeks prior to the survey;	279,382	14,0	12,7;15,4	11,3	10,6;12,0	7,6	4,0;8,5	7,3	6,8;7,9	7,5	6,7;8,3
Sought medical care from the same medical professional or sought for the same health service	279,382	78,5	76,8;80,2	79,2	78,3;80,0	76,0	74,6;77,3	74,4	73,3;75,4	75,9	74,6;77,2
Had a doctor's appointment in the last 12 months	206,384	75,9	75,4;76,4	79,4	78,5;80,3	69,6	69,1;70,3	66,5	65,8;67,1	88,0	87,1,88,9
Had a dentist appointment in the last 12 months	279,382	20,3	18,8;21,9	35,0	33,9;36,1	50,1	48,5;51,6	56,6	55,5;57,6	71,9	70,6;73,2
Sought medical care in health services^b b) In the two weeks prior to the survey;	279,382	23,3	21,6;25,1	23,6	22,6;24,5	19,7	18,5;21,0	20,6	19,7;21,6	26,2	24,9;27,6
Got medical care the first time they sought it^b b) In the two weeks prior to the survey;	6,615	21,9	18,9;25,2	29,1	26,9;31,4	30,7	27,0;34,6	30,7	28,5;33,1	30,0	27,3;32,8
Got medical care and prescriptions filled^b b) In the two weeks prior to the survey;	40,357	65,8	61,3;70,0	61,9	59,2;64,5	62,2	58,4;65,9	59,2	56,6;61,8	51,4	48,0;54,8
Obtained all prescribed medicines (by some means)^c c) In the last health care visit;	24,753	79,7	73,9;84,4	84,3	82,2;86,2	81,5	76,5;85,7	84,6	81,8;87,1	90,0	87,0;92,4
Obtained at least one of the prescribed medicines^c c) In the last health care visit;	24,753	13,2	9,0;18,9	8,2	6,8;10,0	8,2	6,0;11,2	7,3	5,5;9,7	5,1	3,5;7,4
Obtained at least one of the medicines prescribed through the Brazilian Popular Pharmacy Program^c c) In the last health care visit;	22,548	16,5	12,2;22,0	14,2	12,1;16,6	13,3	10,2;17,0	8,7	6,9;10,9	7,6	5,4;10,6
Obtained at least one medicine through the public service^c c) In the last health care visit;	20,501	30,4	24,6;37,0	24,4	21,4;27,5	25,8	20,8;31,5	13,8	11,4;16,7	9,5	7,0;12,8
Have been hospitalized for 24 hours^d d) In the 12 months prior to the survey.	279,382	10,9	9,7;12,3	8,1	7,6;8,8	6,5	5,8;7,3	7,0	6,5;7,6	7,5	6,7;8,4
Last hospitalization occurred in a unit within the Brazilian National Health System	17,392	90,1	86,2;92,9	79,4	75,7;82,6	75,2	69,5;80,1	55,0	50,2;59,5	20,7	16,2;26,1

[1] Correspondence: Nathalia Campos Palmeira | nathalia_camposp@hotmail.com

Brazil

Brazil

Analysis of access to health services in Brazil according to sociodemographic profile: National Health Survey, 2019

ABSTRACT

Objective:

Methods:

Results:

Conclusion: