Dez anos de informação sobre acesso e uso de serviços de saúde

Abstract

. These data serve as an important source for monitoring health policy performance and allow obtaining an overview of access to and use of health services by the population.In the first version, in 1998, prepared by a group of researchers from the Brazilian Association of Graduate Studies in Collective Health (ABRASCO) and the Brazilian Association of Population Studies (ABEP), the questionnaire revisited the health supplement from 1981, adding a section on health insurance coverage. From the methodological point of view, two important corrections were made: the recall times, previously fixed, were changed to consider the time transpired between the events and the interview dates, and the sections on morbidity and health services use were now answered by all the interviewees, which allowed evaluating health services uses even in the absence of a specific health problem. In order to measure health needs, questions were added on chronic non-communicable diseases and limitations in physical activity. The results of the analysis for these ten years suggest major variations in access to and use of health services, resulting from changes in the socioeconomic context and health care policy. Access has increased significantly at all levels. More importantly, the greatest increase in access has occurred in populations living in the poorest regions of the country. However, major geographic and social inequalities still persist, particularly in access to dental services and mammograms.Differences in the services payment profile for persons situated in the highest and lowest per capital family income quintiles indicate that in practice there are two completely distinct systems. While health plans cover most of the care for the wealthier, the Unified National Health System (SUS) has gained importance in payment for services for the poor. However, even the highest income quintile shows an increase in coverage by the National Health System and disbursement when services are used.Data on pharmaceutical care show that despite the increasing access to health services, it is still necessary to evaluate the quality of care and effectiveness of services. In the National Health System, for physician visits involving prescriptions, only 45% of patients received the prescribed medication, thus suggesting low efficiency of care.The health supplement of the National Household Sample Survey has limitations in generating information on quality of care. For 2013, it is hoped that the IBGE will continue to collect this information on the health system's performance, considering adequacy, continuity of care, and users' rights.

The effect of the Family Health Strategy on usual source of care in Brazil: data from the 2013 National Health Survey (PNS 2013)

“…However, it was more pronounced in the Northeast, one of the poorest Regions of the country and in the Central West. In Brazil, inequalities among the population are still very much present and Viacava (2010) analyzing data from 10 years on access and use of health services indicates that access increased significantly in Brazil mainly for those living in the poorest regions of the country [38]. …”

Evolução temporal e diferenciais intra-urbanos da Mortalidade Materna em Aracaju, Sergipe, 2000-2010

“…7 Embora o país disponha de recursos humanos e tecnológicos suicientes para oferecer atenção obstétrica e neonatal de boa qualidade, os resultados alcançados estão abaixo do mínimo desejável. 7,8 Apesar das iniciativas governamentais para reduzir a mortalidade materna, a Razão de Mortalidade Materna (RMM) no país correspondeu a 57,6/100.000 NV, em 2008. Dos 1.685 óbitos maternos registrados, 37,6% ocorreram entre mulheres nordestinas e, destas, 1,5% sergipanas.…”

Perfil Epidemiológico Da População Submetida À Revascularização Cardíaca E Acesso Ao Sistema Único De Saúde

“…A atuação dos profissionais de saúde pode contribuir, ou não, na adesão de práticas que atuem no controle de fatores de risco pelos pacientes, como a qualidade nutricional, o sedentarismo, o estresse, a obesidade, com controle qualificado da condição clínica da doença (22) . Apesar do aumento no acesso aos serviços de saúde, dados sobre a assistência farmacêutica mostram que em apenas 45% dos atendimentos com prescrição, feitos pelo SUS, os pacientes receberam 100% dos medicamentos prescritos (23) . A disponibilidade média de medicamentos na APS no Brasil é de 58,5%, sendo considerada baixa (24) , evidenciada por estudo que mostrou que mais de 50% da população retira medicamento nas farmácias do serviço público de saúde (25) .…”