Use of Health Services In Brazil: A Systematic Review And Meta-Analysis of Prevalence Studies

Araújo, Elza Fernandes de; Andrade, KR; Galvao, TF; Tolentino, M. L. D. de L.; Araújo, Fábio; Pereira, MG

doi:10.1016/j.jval.2015.09.1705

Cited by 5 publications

(7 citation statements)

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“…A systematic review included 659 043 individuals of Brazilian studies and detected a prevalence of 37% of dental visit in the last year, 7 a similar rate to our study. Greater use was observed in individuals with higher income, higher education levels, formal job and health insurance, showing that lower use of dentist services is related to inequities in access.…”

Section: Discussionsupporting

confidence: 87%

“…A systematic review of population-based studies observed an increase in medical and dental consultations from 1998 to 2013 in Brazil countrywide. 7 In the northern—and less developed region—the usage of such health services reduced in this period. Discrepancies in the health services usage in this region may affect the population’s well-being and should be investigated.…”

Section: Introductionmentioning

confidence: 96%

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Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study

et al. 2017

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ObjectivesTo estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access.DesignCross-sectional population-based study.SettingA survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil.Participants4001 adults ≥18 years of age.Primary outcomes measuresPhysician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes. Associated factors were investigated through the calculation of prevalence ratio (PR) obtained by hierarchical Poisson regression modelling.Results4001 adults were included in the study, 53% of whom were women. The self-reported prevalence of medical visits was 77% (95% CI 75% to 77%); dentist visits, 36% (95% CI 34% to 37%) and hospital admission, 7% (95% CI 6% to 7%). Physician visits were higher in women PR=1.18 (95% CI 1.14 to 1.23), the elderly PR=1.18 (95% CI 1.10 to 1.26) and people with health insurance PR=1.14 (95% CI 1.10 to 1.19). Dentist visits declined with older age PR=0.38 (95% CI 0.30 to 0.49), lower education level PR=0.62 (95% CI 0.51 to 0.74) and lower economic class PR=0.65 (95% CI 0.57 to 0.75). Hospitalisations were found to be twice as frequent for women than for men and three times as frequent among those who reported very poor health status. Among the individuals who did not receive medical attention in the previous 2 weeks, 58% reported lack of facilities or appointment unavailable and 14% reported lack of doctors.ConclusionWhile more than half visited the doctor in the last year, a lower proportion of people with socioeconomic inequities visited the dentist. Organisational and service policies are needed to increase equity in health services in the region.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 96%

Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study

et al. 2017

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“…Our findings showed an increased underutilization of health services in Manaus Metropolitan Region when compared with the 2013 Brazilian National Health Survey . Despite being higher than expected, the poor performance in this region was likely due to the reduced rate of healthcare services utilization . Individuals from the North and Northeast regions suffer with lower educational attainment, income and have a lower life expectancy at birth .…”

Section: Discussionmentioning

confidence: 99%

“…In Brazil, the Unified Health System (SUS), in its three decades of existence, has increased the life expectancy of Brazilians and improved sanitary indicators, such as access to healthcare, primary healthcare coverage, hospital births, and rates of hospital admission . A pooling of Brazilian surveys conducted until 2013 showed that over 70% of adults visited a doctor in the previous year, while 37% had a dental consultation, with heterogeneity across regions . Inhabitants of the North—and less developed regions—visited doctors and dentists less than individuals living in the Southwest .…”

Section: Introductionmentioning

confidence: 99%

Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015

Galvão

Tiguman

Caicedo-Roa

et al. 2019

Health Planning & Management

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Summary Background Although Brazil has a public and universal healthcare system, utilization of health services is marked by social and regional discrepancies. Objective To assess the prevalence and factors associated with underutilization of healthcare services in the Brazilian Amazon. Method Cross‐sectional, population‐based study. Adults aged over 18 years old were selected through probabilistic sampling. Underutilization of healthcare services was defined as never seeing a physician or a dentist. Poisson regression with robust variance was performed to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). A complex sample design was considered. Results A total of 4001 individuals were included, of which 419 (10.4%; 95% CI, 9.5‐11.4%) never visited a physician or a dentist. In the adjusted analysis, underutilization was higher among poorer people (PR = 3.32; 95% CI, 2.16‐5.11), men (PR = 1.34; 95% CI, 1.10‐1.65), people with brown skin color (Brazilian mixed race; PR = 1.34; 95% CI, 1.02‐1.76), and people who are separated (PR = 1.40; 95% CI, 1.01‐1.94) and widowed (PR = 1.55; 95% CI, 1.02‐2.37), when compared with the reference categories. Individuals with informal jobs, those who are retired, students/housewives, and unemployed people were more vulnerable to underutilization than formal workers (P < .04). Conclusion Underutilization of healthcare services occurs in one‐tenth of adults in Manaus Metropolitan Region and is associated with social and economic inequities.

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“…Among the attributes of the PHC, the first contact [ 9 ] stands out, defined as “gateway”, which implies accessibility and use of health services by users for each need or problem [ 10 ]. Access refers to the offer, that is, the opportunity or availability of services, and use includes all direct or indirect contact with services, such as consultations, hospitalizations, examinations, and others [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Access and Use of Health Services by People with Diabetes from the Item Response Theory

Siqueira

Guimarães

Pagotto

et al. 2022

IJERPH

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The objective of this study was to analyze the indicators of access and use of health services in people with diabetes mellitus. This study used data from the National Health Survey, conducted in Brazil in 2013. The National Health Survey was carried out with adults aged 18 years or older residing in permanent private households in Brazil. Indicators from 492 individuals with self-reported diabetes mellitus living in the Central–West region of the country were analyzed. Item response theory was used to estimate the score for access to and use of health services. Multiple linear regression was used to analyze factors associated with scores of access and use of health services by people with diabetes mellitus. The mean score of access estimated by the item response theory and use estimated was 51.4, with the lowest score of zero (lowest access and use) and the highest 100 (highest access and use). Among the indicators analyzed, 74.6% reported having received medical care in the last 12 months and 46.4% reported that the last visit occurred in primary care. Only 18.9% had their feet examined and 29.3% underwent eye examinations. Individuals of mixed-race/skin color and those residing outside capital and metropolitan regions had lower access and use scores when compared to white individuals and residents of state capitals, respectively. The study shows several gaps in the indicators of access and use of health services by people with diabetes. People of mixed race/skin color and residents outside the capitals and metropolitan regions had lower scores for access and use, suggesting the need to increase health care in these groups.

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Use of Health Services In Brazil: A Systematic Review And Meta-Analysis of Prevalence Studies

Abstract: Medical doctors were more requested than dentists and hospitals. The use of health services was more concentrated in developed areas. The pooled results of meta-analysis suggest representativeness of Brazilian population for the last decade.

Cited by 5 publications

References 0 publications

Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study

Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study

Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015

Access and Use of Health Services by People with Diabetes from the Item Response Theory

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