الملخص
Resumo Este estudo investigou a utilização dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos. A amostra foi composta por 416 diabéticos cadastrados na Estratégia Saúde da Família de um município do Nordeste do Brasil. A análise dos dados incluiu estatísticas descritivas, bivariadas e multivariada por meio da modelagem de Árvore de Decisão usando o algoritmo Chi-squared Automatic Interaction Detector (CHAID). Evidenciou-se expressiva utilização dos serviços públicos de saúde (80,7%). A utilização do serviço público de saúde com regularidade envolveu indivíduos com escolaridade baixa ou média (p < 0,001), empregados ou aposentados e/ou pensionistas (p = 0,019), com alto impacto do diabetes na qualidade de vida (p = 0,032), e que realizavam a quantidade recomendada de exames de glicemia em jejum ao ano (p < 0,001). A utilização dos serviços de saúde pôde ser explicada por diferenças relacionadas aos determinantes sociais, aos comportamentos em saúde e ao impacto do diabetes na qualidade de vida dos usuários.
Abstract The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.
الموضوعات
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Quality of Life , Health Behavior , Patient Acceptance of Health Care , Diabetes Mellitus/therapy , Social Determinants of Health , Facilities and Services Utilization/statistics & numerical data , Brazil , Urban Health , Cross-Sectional Studies , Middle Agedالملخص
Abstract Objective: To investigate the socioeconomic, demographic and health needs that influence the access to oral health actions. Material and Methods: The sample consisted of 609 individuals who lived in areas covered by the Family Health Strategy in a city of the Northeast of Brazil. All individuals living in areas covered by the FHS with age equal to or higher than six years were included. Data analysis included descriptive, bivariate and multivariate statistics using decision-tree based Chi-squared automatic interaction detection (CHAID). Results: Most participants were female, aged 25-34 years, ranging in age from 6 to 87 years. It was evidenced that, among the studied variables, the most relevant for understanding the access to oral health actions were: age (p<0.001), educational level (p-value in Node 1 = 0.009; p-value in Node 7 = 0.005) and self-perception of oral health (p=0.001). Conclusion: The results suggest that access to oral health actions is influenced by several social and individual factors, and it is marked by inequalities that favor individuals with higher educational level, better self-perception of oral health and lower age groups.