Association between socioeconomic factors and origin of hospital referrals among patients with oral cancer

ABSTRACT

Background: The Brazilian Unified Health System (SUS) is responsible for offering free assistance to more than100 million Brazilians, including treatment of oral cancer lesions. Considering that the Brazilian public systemaids the most vulnerable population, this study analyzed whether the origin of hospital referrals of patients withoral cancer is associated with socioeconomic factors.Material and Methods: A cross-sectional study was carried out from cancer hospital records of the National Cancer Institute (RHC-INCA), considering the primary locations (C00 to C06) diagnosed between 2016 and 2019.Data on gender, skin color (white and non-white), education (no schooling, incomplete or complete elementaryeducation; high school; incomplete and complete higher education) and origin of referral (SUS and non-SUS) wereanalyzed by multiple logistic regression (p<0.05).Results: Higher referral rates by the SUS were observed in 2017 (OR=1.27; 95% CI=1.098-1.480) and 2018(OR=1.28; 95% CI=1.101-1.490); no differences were found between the years 2016 and 2019. Regarding gender,men were 40% more likely to have the SUS as the source of referral (OR=1.40; 95% CI=1.233-1.600). Non-whiteindividuals were 34% more likely to have the SUS as the source of the referral (OR=1.34; 95% CI=1.190-1.512). Illiterate individuals or individuals who only attended elementary school were 6.38 times more likely to be referredby the SUS than individuals with higher education (OR=6.38; 95% CI=5.228-7.796).Conclusions: It is concluded that the origin of hospital referrals via SUS of patients with oral cancer is associatedwith socioeconomic factors. (AU)