scholarly journals Use of and access to health services in Brazil, 2013 National Health Survey

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Sheila Rizzato Stopa ◽  
Deborah Carvalho Malta ◽  
Camila Nascimento Monteiro ◽  
Célia Landmann Szwarcwald ◽  
Moisés Goldbaum ◽  
...  

ABSTRACT OBJECTIVE To analyze the use of health services in the Brazilian population by sociodemographic factors, according to data from the 2013 Brazilian National Health Survey. METHODS The study analyzed data from 205,000 Brazilian citizens in all age groups who participated in the Brazilian National Health Survey, a cross-sectional study carried out in 2013. Prevalence and confidence intervals were estimated for indicators related to access to and use of health services according to age group, level of education of head of household, and Brazilian macroregions. RESULTS Among individuals who sought health services in the two weeks prior to the survey, 95.3% (95%CI 94.9–95.8) received care in their first visit. Percentages were higher in the following groups: 60 years of age and over; head of household with complete tertiary education; living in the South and Southeast regions. In addition, 82.5% (95%CI 81.2–83.7) of individuals who received health care and prescriptions were able to obtain all the necessary medicines, 1/3 of them from SUS. Less than half the Brazilian population (44.4%; 95%CI 43.8–45.1) visited a dentist in the 12 months prior to the survey, with smaller percentages among the following groups: 60 years of age or older; head of household with no education or up to incomplete elementary; living in the North region of Brazil. CONCLUSIONS People living in the South and Southeast regions still have greater access to health services, as do those whose head of household has a higher level of education. The (re)formulation of health policies to reduce disparities should consider differences encountered between regions and social levels.

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Margareth Guimarães Lima ◽  
Silvânia Suely Caribé de Araújo ◽  
Marta Maria Alves da Silva ◽  
...  

ABSTRACT OBJECTIVE To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD). METHODS Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals. RESULTS The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53–1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78–3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24–1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. CONCLUSIONS NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.


2019 ◽  
Vol 22 (12) ◽  
pp. 2147-2154 ◽  
Author(s):  
Ana Paula Alves de Souza ◽  
Paulo Rogério Melo Rodrigues ◽  
Ana Paula Muraro ◽  
Naiara Ferraz Moreira ◽  
Rosely Sichieri ◽  
...  

AbstractObjectiveTo identify cut-off points for waist circumference (WC), waist-to-height ratio (WHtR) and BMI associated with hypertension in the Brazilian adult and elderly population.DesignCross-sectional study. The receiver-operating characteristic (ROC) curve was used to determine the cut-off points of WC, WHtR and BMI in the prediction of hypertension. Those who had systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and those who reported use of antihypertensive medication were considered hypertensive.SettingBrazil.ParticipantsParticipants from the National Health Survey, the Brazilian household-based survey conducted in 2013, of both sexes and age ≥20 years.ResultsCut-off points for WC and WHtR increased with age in both sexes. WC cut-off limits ranged between 88·0 and 95·9 cm in men and between 85·0 and 93·2 cm in women. For WHtR, cut-off scores ranged from 0·51 to 0·58 for men and from 0·53 to 0·61 for women. Additionally, the area under the ROC curve (AUC) for all age and sex groups was greater than 0·60 while the lower limit of the AUC 95 % CI for both WC and WHtR was not less than 0·50. The performance of BMI was similar to that of indicators of fat location.ConclusionsAll analysed anthropometric indicators had similar performance in identifying hypertension in the Brazilian population.


2016 ◽  
Vol 134 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Nadir Baltazar dos Santos ◽  
Rosângela Durso Perillo ◽  
Célia Landmann Szwarcwald

ABSTRACT: CONTEXT AND OBJECTIVE: High blood pressure (hypertension) is the most frequent cause of morbidity and a major risk factor for cardiovascular complications. The aim here was to describe the prevalence of blood pressure greater than or equal to 140/90 mmHg in the adult Brazilian population and federal states, along with self-reported information about previous medical diagnoses of hypertension, use of medication and medical care for hypertension control. DESIGN AND SETTING: Cross-sectional study analyzing information from the National Health Survey of 2013, relating to Brazil and its federal states. METHODS: The sample size was estimated as 81,254 households and information was collected from 64,348 households. The survey consisted of interviews, physical and laboratory measurements. Systolic blood pressure was considered to be high when it was ≥ 140 mmHg and diastolic blood pressure, ≥ 90 mmHg. RESULTS: It was found that 22.8% of the population has blood pressure measurements ≥ 140/90 mmHg. The proportion was higher among men than among women: 25.8% versus 20.0%. The frequency increased with age, reaching 47.1% in individuals over 75 years and was highest in the southeast and south. 43.2% reported previous medical diagnoses of hypertension and, of these, 81.4% reported using medication for hypertension and 69.6%, going to the doctor within the past year for pressure monitoring, thus showing regular medical follow-up. CONCLUSION: These results are important for supporting measures for preventing and treating hypertension in Brazil, with the aim of achieving the World Health Organization's goal of reducing hypertension by 25% over the next decade.


2019 ◽  
Vol 24 (3) ◽  
pp. 259
Author(s):  
Herna Lestari ◽  
Atnike Nova Sigiro

<p>The availability of reproductive and sexual health services provided by the National Health Insurance (Jaminan Kesehatan National/JKN) in Indonesia could expand women’s access to reproductive and sexual health services. However, the knowledge of community and service provider will determine to what extent women will access the reproductive and sexual health services provided by JKN. This article assesses and analyzes the knowledge of women and health officers about the availability of reproductive and sexual health services provided in JKN. The article elaborates for main findings from the research that was conducted by women organizations that are members of the Women’s Health Care Network (Jaringan Perempuan Peduli Kesehatan or JP2K). JP2K conducted longitudinal research with a series of surveys in 2015, 2016, and 2017 in 15 regions of districts/cities in Indonesia on knowledge and access to reproductive and sexual health services provided by JKN. The surveys show limited knowledge of the respondents, both women and health officers, about forms and scope of reproductive and sexual health services that are covered by JKN. The research concludes that one of the important agendas for encouraging women’s access to health services covered by JKN is through intensifying the socialization of the scope of sexual and reproductive health to women and health facility officers.</p>


2019 ◽  
Vol 22 (suppl 2) ◽  
Author(s):  
Tássia Fraga Bastos ◽  
Lhais de Paula Barbosa Medina ◽  
Neuciani Ferreira da Silva Sousa ◽  
Margareth Guimarães Lima ◽  
Deborah Carvalho Malta ◽  
...  

ABSTRACT: Introduction: Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. Objective: To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. Methods: Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. Results: Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. Conclusion: Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.


Author(s):  
Paulo A. Lotufo ◽  
Raul D. Santos ◽  
Andrei C. Sposito ◽  
Marcelo Bertolami ◽  
Jose Rocha-Faria Neto ◽  
...  

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