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Inequity in utilizing health services in the Brazilian Amazon: A population-based survey, 2015.
Int J Health Plann Manage ; 34(4): e1846-e1853, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31515900


Although Brazil has a public and universal healthcare system, utilization of health services is marked by social and regional discrepancies.


To assess the prevalence and factors associated with underutilization of healthcare services in the Brazilian Amazon.


Cross-sectional, population-based study. Adults aged over 18 years old were selected through probabilistic sampling. Underutilization of healthcare services was defined as never seeing a physician or a dentist. Poisson regression with robust variance was performed to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). A complex sample design was considered.


A total of 4001 individuals were included, of which 419 (10.4%; 95% CI, 9.5-11.4%) never visited a physician or a dentist. In the adjusted analysis, underutilization was higher among poorer people (PR = 3.32; 95% CI, 2.16-5.11), men (PR = 1.34; 95% CI, 1.10-1.65), people with brown skin color (Brazilian mixed race; PR = 1.34; 95% CI, 1.02-1.76), and people who are separated (PR = 1.40; 95% CI, 1.01-1.94) and widowed (PR = 1.55; 95% CI, 1.02-2.37), when compared with the reference categories. Individuals with informal jobs, those who are retired, students/housewives, and unemployed people were more vulnerable to underutilization than formal workers (P < .04).


Underutilization of healthcare services occurs in one-tenth of adults in Manaus Metropolitan Region and is associated with social and economic inequities.





Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Int J Health Plann Manage Assunto da revista: Pesquisa em Serviços de Saúde / Serviços de Saúde Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Brasil