Inequities in access to mammographic screening in Brazil.
Cad Saude Publica
; 35(6): e00099817, 2019 07 04.
Article
en En
| MEDLINE
| ID: mdl-31291424
ABSTRACT
Our objectives with this study were to describe the spatial distribution of mammographic screening coverage across small geographical areas (micro-regions) in Brazil, and to analyze whether the observed differences were associated with spatial inequities in socioeconomic conditions, provision of health care, and healthcare services utilization. We performed an area-based ecological study on mammographic screening coverage in the period of 2010-2011 regarding socioeconomic and healthcare variables. The units of analysis were the 438 health micro-regions in Brazil. Spatial regression models were used to study these relationships. There was marked variability in mammographic coverage across micro-regions (median = 21.6%; interquartile range 8.1%-37.9%). Multivariable analyses identified high household income inequality, low number of radiologists/100,000 inhabitants, low number of mammography machines/10,000 inhabitants, and low number of mammograms performed by each machine as independent correlates of poor mammographic coverage at the micro-region level. There was evidence of strong spatial dependence of these associations, with changes in one micro-region affecting neighboring micro-regions, and also of geographical heterogeneities. There were substantial inequities in access to mammographic screening across micro-regions in Brazil, in 2010-2011, with coverage being higher in those with smaller wealth inequities and better access to health care.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
11_ODS3_cobertura_universal
/
1_ASSA2030
/
2_ODS3
Problema de salud:
11_delivery_arrangements
/
11_multisectoral_coordination
/
1_acesso_equitativo_servicos
/
2_cobertura_universal
Asunto principal:
Neoplasias de la Mama
/
Mamografía
/
Disparidades en Atención de Salud
/
Accesibilidad a los Servicios de Salud
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Screening_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Aged
/
Female
/
Humans
/
Middle aged
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Cad Saude Publica
Asunto de la revista:
SAUDE PUBLICA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Brasil