Medicine access and utilization in a population covered by primary helth care in Brazil

ABSTRACT

Objetives To describe medicine utilization and access in a population covered by the Family Health Program (PSF) in Brazil.Methods: Cross-sectional study with a random sample of 2988 individuals living in areas covered by 45 PSF clinics. Medicine utilization in the 15 days prior to the interview was assessed, as well as lack of access to medicines (proportion of people with medicines needed but not used), and lack of free access thorough the PSF (proportion of medicines used which had to be purchased).Results: Overall, 54.5 percent (95 percent CI 50.6; 58.4) of individuals used at least one medicine in the 15-day period and 3.6 percent reported failing to use a needed medicine. Of all medicines used, 41.5 percent were paid for out-of-pocket (25.5 percent among the poorest families), and 51.0 percent were obtained for free from the PSF. Almost 90 percent of the medicines prescribed by PSF physicians were provided for free by the PSF.Conclusion: Although medicine access was high, individuals paid out-of-pocket for a substantial proportion of the medicines used. Lack of availability in PSF facilities and prescribing by non-PSF providers seem to contribute to the need for out-of-pocket purchases, and thus can be targeted for improvement through PSF policies.(AU)