OBJECTIVE To analyze the use of health services in the Brazilian population by sociodemographic factors, according to data from the 2013 Brazilian National Health Survey.METHODS The study analyzed data from 205,000 Brazilian citizens in all age groups who participated in the Brazilian National Health Survey, a cross-sectional study carried out in 2013. Prevalence and confidence intervals were estimated for indicators related to access to and use of health services according to age group, level of education of head of household, and Brazilian macroregions.RESULTS Among individuals who sought health services in the two weeks prior to the survey, 95.3% (95%CI 94.9–95.8) received care in their first visit. Percentages were higher in the following groups: 60 years of age and over; head of household with complete tertiary education; living in the South and Southeast regions. In addition, 82.5% (95%CI 81.2–83.7) of individuals who received health care and prescriptions were able to obtain all the necessary medicines, 1/3 of them from SUS. Less than half the Brazilian population (44.4%; 95%CI 43.8–45.1) visited a dentist in the 12 months prior to the survey, with smaller percentages among the following groups: 60 years of age or older; head of household with no education or up to incomplete elementary; living in the North region of Brazil.CONCLUSIONS People living in the South and Southeast regions still have greater access to health services, as do those whose head of household has a higher level of education. The (re)formulation of health policies to reduce disparities should consider differences encountered between regions and social levels.

BackgroundAccess to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the “Smiling Brazil” Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003.MethodData was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored.ResultsOverall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups.ConclusionsThe Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1928-y) contains supplementary material, which is available to authorized users.

Portuguese / English: www.scielo.br/reeusp RESUMO O trauma frequentemente está associado à incapacidade funcional, tornando-se uma importante questão social, econômica e de saúde. O estudo busca avaliar a independência funcional de idosos com fratura, na admissão, alta, e após um mês em domicí-lio, e também verificar suas relações com as variáveis demográficas e de saúde. Trinta e quatro idosos hospitalizados no Instituto de Ortopedia e Traumatologia do HCFMUSP foram entrevistados e submetidos à aplicação da Medida de Independên-cia Funcional (MIF). Das fraturas, 67,6% eram de fêmur. Os valores da MIF motora e total aumentaram na alta; já os valores da MIF total diminuíram após um mês em domicílio. A incapacidade funcional aumentou com a idade e para um maior número de dias de internação. O hipotireoidismo foi associado à incapacidade cognitiva, ao passo que a demência e a depressão foram associadas à incapacidade motora. DESCRITORES ABSTRACTTrauma is often related to functional impairment, representing an important social, economic and health issue. This study intended to evaluate the functional independence of aged individuals with fractures, at admission, discharge and after one month from their regressing home. Furthermore, this study also intended to verify the relationship between functional independence and demographic and health variables. Thirty-four aged individuals hospitalized at the Orthopedics and Traumatology Institute of the University of São Paulo Faculty of Medicine were interviewed and submitted to the application of the Functional Independence Measure (FIM). Among all fractures, 67.6% were femur fractures. The motor and total FIM scores increased at discharge; on the other hand, the total FIM score decreased one month after their returning home. Functional impairment increased with age and also with longer length of stay. Hypothyroidism was related to cognitive impairment, while dementia and depression were related to motor impairment. KEY WORDS RESUMENEl trauma es frecuentemente asociado con la incapacidad funcional, convirtiéndose en un importante tema social, económico y de salud. El estudio busca evaluar la independencia funcional de ancianos con fracturas en la admisión, al momento del alta y después de un mes en domicilio, incluso así como verificar sus relaciones con las variables demográficas y de salud. Treinta y cuatro ancianos hospitalizados en el Instituto de Ortopedia y Traumatología del HCFMUSP fueron entrevistados y sometidos a la aplicación de la Medida de Independencia Funcional (MIF). Las fracturas fueron del fémur en un 67,6%. Los valores de la MIF motora y total aumentaron para el momento del alta; ya los valores de la MIF total disminuyeron después de un mes en domicilio. La incapacidad funcional aumentó con la edad, haciendo necesario un mayor número de días de hospitalización. El hipotiroidismo se asoció a la incapacidad cognitiva, mientras que la demencia y la depresión se asociaron a la incapacidad motriz. DESCRIPTORES

with adequate provision of health care and full access to medicine, sociodemographic, behavioral and clinical factors did not influence adherence to medicine indicating that health service organization and health policies play a fundamental role in controlling hypertension.

despite the low vaccination coverage against influenza and pneumonia in the population with diabetes mellitus since 2003 the utilization of SUS to vaccination has been progressively expanding.

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The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.

À Deus por guiar meus passos, iluminar minha mente e me levantar nos momentos de dificuldades. Aos meus pais, Adelino e Suzete por me fornecerem o alicerce para chegar até aqui. Ao meu marido Marcelo, pelo amor, companheirismo, total compreensão e ajuda, especialmente quando mais precisei. À minha querida avó Guiomar, pelos afagos e palavras de força quando precisei. Ao meu querido avô Antônio, que partiu no decorrer do trajeto deste projeto deixando imensa saudade, por seus ensinamentos de carisma e persistência. Ao meu irmão Guto, meu amigo, pela torcida e colaboração incondicional. A Prof a Dr a Ana Crisitina, a quem sustento imensa admiração. Meu muito obrigado por seus ensinamentos, agradável convivência de longa data e por depositar, por mais uma vez, a sua confiança no meu potencial. À Chefe de Divisão Materno-Infantil do HU-USP, Alda Valéria e às Chefes das Unidades neonatal e UTI neonatal, Eliete e Fabiana respectivamente, por disponibilizarem as unidades e suas equipes para que fosse possível a realização deste estudo. Às técnicas administrativas da Unidade Neonatal e UTI neonatal, Sueli e Luciana respectivamente, pela disponibilidade no fornecimento de informações necessárias ao andamento da coleta de dados. Aos trabalhadores de enfermagem das Unidades Neonatal, UTI Neonatal e Banco de leite humano pela disponibilidade e participação neste estudo. À Daniela Pires Nunes, colega de pós-graduação, pela disponibilidade e ensinamentos sobre o tratamento estatístico deste trabalho. Às Enfermeiras da Unidade Neonatal do HU-USP, ex colegas de trabalho e também às Enfermeiras Especialistas do Departamento ENC da EEUSP, atuais colegas de trabalho, pelo incentivo, compreensão e flexibilidade, para que eu pudesse cumprir as atividades de pós-graduanda. À todos aqueles que torceram e que de alguma forma colaboraram para a realização deste trabalho, meus agradecimentos.