Socioeconomic inequalities in the access to and quality of health care services

Abstract

OBJECTIVETo assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status.METHODSThis population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses.RESULTSThe lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status.CONCLUSIONSAlthough no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

Procura por serviços ou profissionais de saúde entre adolescentes brasileiros, segundo a Pesquisa Nacional de Saúde do Escolar de 2015

“…Data from the National Household Sample Survey (PNAD) indicate an increase in the use of health services and point to a reduction in the inequalities of access to primary health care [29][30] , but such inequalities persist, mainly in relation to income. These differences may relate the demand for care, which is higher among people with lower income [31][32][33][34] .…”

Inequalities in multimorbidity among elderly: a population-based study in a city in Southern Brazil

“…Although more than 90% of the elderly have at least two chronic diseases, no socioeconomic inequalities were found for the cut-off points of 2+ and 3+ health conditions. These findings may be explained by the population at lower economic and schooling levels being more affected by chronic diseases, due to their general health scenario: less access to and use of health services, and worse conditions for maintaining a healthy lifestyle 38,39 . Also, according to the literature, the lower the socioeconomic condition, the higher the prevalence of multimorbidities 12,29 .…”

Fatores associados ao tratamento e ao controle do tratamento do tracoma em escolares de município da Região Nordeste, Brasil

“…Improving access to sanitation and water are recommendations present in the SAFE strategy, to reach the goal of eliminating this disease 1 . In a study carried out in Pelotas, RS, the authors found a predominance in the lack of access to health services among people with lower economic conditions 16 .…”