Inequalities in the use of health services by adults and elderly people with and without noncommunicable diseases in Brazil, 2019 National Health Survey

Abstract

Objective: The objective of this study was to investigate the use of health services and limitations in performing usual activities by adults and elderly people with and without noncommunicable chronic diseases (NCDs), according to sociodemographic strata. Methods: This is a cross-sectional study in which data from the 2019 National Health Survey were analyzed. The final sample corresponded to 88,531 households with interviews carried out, referring to individuals aged 18 years and above. The prevalence of use of services by the population with NCDs was compared with that of the population without NCDs and stratified by socioeconomic and demographic variables. Prevalence ratios (PRs) and 95% confidence intervals (95%CI) were calculated. Results: In 2019, 47.6% (95%CI 47.0–48.3) of the population reported having one or more NCDs. Population with NCDs had more medical consultations in the last 12 months (adjusted PR [APR]=1.21; 95%CI 1.20–1.23), used more health services in the last 2 weeks (APR=2.01; 95%CI 1.91–2.11), were referred to more hospitalization (APR=2.11; 95%CI 1.89–2.36), and had more limitations in performing usual activities (APR=2.52; 95%CI 2.30–2.76), compared with the population without NCDs. A positive dose–response gradient was observed between the number of comorbidities and the use of services. In all socioeconomic and demographic strata, the prevalence of indicators was higher in people with NCDs. Conclusion: The presence of NCDs was associated with a higher frequency of use of health services (i.e., consultation, use of services, and hospitalization) and the restriction of usual activities in all socioeconomic and demographic strata.

Challenges and perspectives in the work of stomatherapists during the COVID-19 pandemic

“…Essa lacuna na atenção especializada foi observada em outros estudos, sobretudo quanto à redução dos atendimentos ambulatoriais, a dificuldade de acesso aos centros de saúde e o receio de adquirir a infecção por COVID-19. (14)(15)(16) Esta situação levou ao agravamento de condições crônicas e, consequentemente, um aumento no custo do cuidado, como citado pelas participantes. Outrossim, refletiu diretamente em indicadores de saúde, a exemplo o aumento do número de amputações e desarticulações de membros inferiores, sobretudo devido a complicações do pé diabético.…”

Factors associated with demand for emergency medical services by people with hypertension and diabetes

“…With regard to sex, men’s preferential demand for ER services is influenced by cultural and social issues that involve the determinants of the health-disease process and permeate the use of health services ( 13 , 24 ) . The higher proportion of AH and/or DM diagnosis registration in women can be explained by the fact that they are more diligent about symptoms, seek greater knowledge about the condition and attend health units more ( 21 , 25 ) . It should be noted that, in ER services, it is common for men to be accompanied by their wives, who are often the ones who report their partner’s complaints, highlighting their role as caregivers within the family nucleus ( 26 ) .…”

Chronic diseases and emotional disorders are associated with low perception of quality of life in food insecurity/security

“…Another point of reflection is about self-reported health conditions. Self-reported morbidities are related to access to health services, which is higher in individuals with better socioeconomic status and lower in more vulnerable people, with lower education and lower income ( 38 ). Although Brazil has a Brazilian Public Health System (SUS), which guarantees access to health services by the population with less education, lower income and without health insurance ( 39 ), this population may have greater difficulty in receiving medical care, diagnosis and access to medical consultations.…”