Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

Santiago, Adriana; Barreto, Ivana Cristina de Holanda Cunha; Sucupira, Ana Cecília Silveira Lins; Lima, José Wellington de Oliveira; Andrade, Luiz Odorico Monteiro de

doi:10.1590/1809-4503201400060004

Cited by 6 publications

(7 citation statements)

References 21 publications

(38 reference statements)

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“…Authors have published these studies between 1999 and 2017 (median: 2009) 5,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37 (Table 1). The authors of five studies reported having no conflicts of interest 19,28,31,33,35 , while in the other studies the authors did not disclose whether they had any conflicts of interest, nor did they examine interviewers' biases (in qualitative studies).…”

Section: Resultsmentioning

confidence: 99%

“…While some studies had national coverage 5,12,13,14,22,24,25 , others covered certain geographical regions (e.g., Northeast or Southeast) 8,11,15,20,26 , states 16,33 , metropolitan areas 9,17,18 , municipalities 10,19,21,23,27,28,30,31,34,35,36,37 or parts of a municipality 22,32 . The study population included varied age groups, but most of them showed a balanced gender composition, with the exception of one study about men's health 37 and two about women's health 19,31 .…”

Section: Resultsmentioning

confidence: 99%

“…The study population included varied age groups, but most of them showed a balanced gender composition, with the exception of one study about men's health 37 and two about women's health 19,31 . In the quantitative studies, the proportion of privately insured people ranged from 5.7% 35 to 70.7% 27 , while in the qualitative studies all participants were privately insured 9,15,20,26 .…”

Section: Resultsmentioning

confidence: 99%

“…In most quantitative studies, participants were sampled through household surveys, such as Equity-LA 33 ; Health, Well-being and Aging (SABE, in Portuguese) 28 Survey (PNAD, in Portuguese) 5,12,14,22,24,25 ; World Health Survey (WHS) 13 ; Living Standards Survey (PPV, in Portuguese) 8,11 ; Health Survey in Campinas (ISACamp, in Portuguese) 31 ; Health and Diet Survey -Capital (ISA-Capital, in Portuguese) 34 ; and Survey of Living Conditions (PCV, in Portuguese) 16,17,18 , among others 10,21,37 . Other quantitative studies sampled patients from the Family Health Strategy (FHS) registry 23,27,29,32,35 or from utilization of health service 19,30,36 . A quantitative study 8 included data from an opinion poll whose methods we could not verify.…”

Section: Resultsmentioning

confidence: 99%

“…A quantitative study 8 included data from an opinion poll whose methods we could not verify. In qualitative studies including patients 15,20,26 , participants undergone intentional or snowballing sampling, based on the utilization of health services, participation in support groups or patients association groups or from the Brazilian Information System on Live Births (SINASC, in Portuguese); data were collected through focus Note: studies 19,28,31,33,35 reported having no conflicts of interest but the others did not disclose whether there was a conflict of interest;…”

Section: Resultsmentioning

confidence: 99%

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Utilization of the Brazilian public health system by privately insured individuals: a literature review

et al. 2019

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More than one in four Brazilians have private health insurance (PHI), even thought it covers mostly the same procedures as the Brazilian Unified National Health System (SUS). This literature review included articles and monographs published since 1990 about the utilization of SUS by privately insured individuals. Considering outpatient care and hospitalization, privately insured people in Brazil use SUS in approximately 13% of the times they receive health care, and approximately 7% of people receiving care paid by SUS are privately insured; these findings vary depending on the type of service studied and on study methods. Utilization of SUS is more frequent in less developed regions, by people with more restricted PHI plans and by people with worse health status. Privately insured people report the limitations of PHI plans as their reasons for resorting to SUS. Sometimes, beneficiaries of PHI plans owned by nonprofit hospitals (which also provide health care financed by SUS) have easier access to care than uninsured people financed by SUS. Anecdotally, privately insured people are satisfied with SUS, but not to the point of adopting SUS as their preferred source of care. In short, for privately insured people, SUS only plays a secondary role in their health care. Despite PHI taking over part of the SUS’s health care demand, PHI represents a restriction of the universal, equitable character of the SUS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Utilization of the Brazilian public health system by privately insured individuals: a literature review

et al. 2019

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Brazil’s Family Health Strategy: factors associated with programme uptake and coverage expansion over 15 years (1998–2012)

Andrade

Coelho

Neto

et al. 2018

Health Policy and Planning

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Universal Health Coverage (UHC) is one of the United Nations Sustainable Development Goals (SDGs). Achieving UHC will require strong health systems to promote and deliver equitable and integrated healthcare services through primary healthcare (PHC). In Brazil, the Family Health Strategy (FHS) delivers PHC through the public health system. Created in 1994, the FHS covered almost 123 million individuals (63% of the Brazilian population) by 2015. The FHS has been associated with many health improvements, but gaps in coverage still remain. This article examines factors associated with the implementation and expansion of the FHS across 5419 Brazilian municipalities from 1998 to 2012. The proportion of the municipal population covered by the FHS over time was assessed using a longitudinal multilevel model for change that accounted for variables covering eight domains: economic development, healthcare supply, healthcare needs/access, availability of other sources of healthcare, political context, geographical isolation, regional characteristics and population size. Data were obtained from multiple publicly available sources. During the 15-year study period, national coverage of the FHS increased from 4.4% to 54%, with 58% of the municipalities having population coverage of 95% or more, and municipalities that had not adopted the programme decreased from 86.4% to 4.9%. The increase in FHS uptake and coverage was not homogenous across municipalities, and was positively associated with small population size, low population density, low coverage of private health insurance, low level of economic development, alignment of the political party of the Mayor and the state Governor, and availability of healthcare supply. Efforts to expand the FHS coverage will need to focus on increasing the availability of health personnel, devising financial incentives for municipalities to uptake/expand the FHS and devising new policies that encompass both private and public sectors.

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Utilization of basic health units of FHS according to private health insurance

et al. 2018

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OBJECTIVETo describe the utilization of basic health units according to coverage by discount card or private health insurance.METHODSHousehold survey in the area covered by Family Health Strategy in Pelotas, state of Rio Grande do Sul, Brazil, from December 2007 to February 2008, with persons of all age groups. The frequency of (medical or non-medical) healthcare seeking at the basic health units in the last six months and the prevalence of basic health unit utilization for the last medical consultation (in case it had been performed up to six months before, for a non-routine reason) were analyzed by Poisson regression adjusted for the sampling design.RESULTSOf the 1,423 persons, 75.6% had no discount card or private health insurance. The average frequency of (medical or non-medical) healthcare seeking was 1.6 times in six months (95%CI 1.3-2.0); this frequency was 55.8% lower (p < 0.001) among privately insured persons compared to those with no discount card or private health insurance. Among the last medical consultations, 35.8% (95%CI 25.4-47.7) had been performed at the basic health units; this prevalence was 36.4% lower (p = 0.003) among persons covered by discount card and 87.7% lower (p = 0.007) among privately insured persons compared to those without both coverages.CONCLUSIONSPrivate health insurance and, to a lesser degree, discount card coverage, are related to lower utilization of basic health units. This can be used to size the population under the accountability of each Family Health Strategy team, to the extent that community health workers are able to differentiate discount card from PHI during family registration.

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Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

Abstract: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

Cited by 6 publications

References 21 publications

Utilization of the Brazilian public health system by privately insured individuals: a literature review

Utilization of the Brazilian public health system by privately insured individuals: a literature review

Brazil’s Family Health Strategy: factors associated with programme uptake and coverage expansion over 15 years (1998–2012)

Utilization of basic health units of FHS according to private health insurance

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