Horizontal equity in health care utilization in Brazil, 1998 2008

Detalhes bibliográficos
Autor(a) principal: Macinko, James
Data de Publicação: 2012
Outros Autores: Costa, Maria Fernanda Lima
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/7663
Resumo: New York University. Food Studies and Public Health. Department of Nutrition. New York, NY, USA
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spelling Macinko, JamesCosta, Maria Fernanda Lima2014-05-28T18:01:59Z2014-05-28T18:01:59Z2012MACINKO, James; COSTA, Maria Fernanda Lima. Horizontal equity in health care utilization in Brazil, 1998 2008. International Journal for Equity in Health. 2012, vol.11, pp. 33.1475-927https://www.arca.fiocruz.br/handle/icict/766310.1186/1475-9276-11-33engBioMed CentralHorizontal equity in health care utilization in Brazil, 1998 2008info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleNew York University. Food Studies and Public Health. Department of Nutrition. New York, NY, USAFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Epidemiologia e Antropologia Médica. Belo Horizonte, MG, Brasil/Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.Introduction: This study assesses trends in horizontal equity in the utilization of healthcare services from 1998 to 2008--a period of major economic and social change in Brazil. Methods: Data are from nationally representative surveys repeated in 1998, 2003, and 2008. We apply established methods for assessing horizontal inequity in healthcare access (the principle that people with the same healthcare needs should have similar access to healthcare services). Horizontal inequity is calculated as the difference between observed healthcare utilization and utilization predicted by healthcare needs. Outcomes examined include the probability of a medical, dental, or hospital visit during the past 12 months; any health service use in the past two weeks; and having a usual source of healthcare. We use monthly family income to measure differences in socioeconomic position. Healthcare needs include age, sex, self-rated health, and chronic conditions. Non-need factors include income, education, geography, health insurance, and Family Health Strategy coverage. Results: The probability of having at least one doctor visit in the past 12 months became substantially more equitable over time, ending with a slightly pro-rich orientation in 2008. Any hospitalization in the past 12 months was found to be pro-poor in all periods but became slightly less so in 2008. Dental visits showed the largest absolute decrease in horizontal inequity, although they were still the most inequitably (pro-rich) distributed outcome in 2008. Service use in the past two weeks showed decreased inequity in 2003 but exhibited no significant change between 2003 and 2008. Having a usual source of care became less pro-rich over time and was nearly income-neutral by 2008. Factors associated with greater inequities include income, having a private health plan, and geographic location. Factors associated with greater equity included health needs, schooling, and enrolment in the Family Health Strategy. Conclusions: Healthcare utilization in Brazil appears to have become increasingly equitable over the past 10 years. Although this does not imply that equity in health outcomes has improved correspondingly, it does suggest that government policies aimed at increasing access, especially to primary care, have helped to make healthcare utilization in Brazil fairer over time.HealthcareBrazilAccess to carePrimary careinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALHorizontal equity in health care .pdfHorizontal equity in health care .pdfapplication/pdf1974671https://www.arca.fiocruz.br/bitstream/icict/7663/1/Horizontal%20equity%20in%20health%20care%20.pdf5ed51abb70787a2bf7a9ba50bc08645fMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81914https://www.arca.fiocruz.br/bitstream/icict/7663/2/license.txt7d48279ffeed55da8dfe2f8e81f3b81fMD52TEXTHorizontal equity in health care .pdf.txtHorizontal equity in health care .pdf.txtExtracted texttext/plain8https://www.arca.fiocruz.br/bitstream/icict/7663/5/Horizontal%20equity%20in%20health%20care%20.pdf.txt8d1b69dd9bdc9df4a8073c7a8193c7afMD55THUMBNAILHorizontal equity in health care .pdf.jpgHorizontal equity in health care .pdf.jpgGenerated Thumbnailimage/jpeg1952https://www.arca.fiocruz.br/bitstream/icict/7663/4/Horizontal%20equity%20in%20health%20care%20.pdf.jpg31c181cc91eb3538db5d5c3f97163754MD54icict/76632018-04-06 08:48:44.038oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352018-04-06T11:48:44Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Horizontal equity in health care utilization in Brazil, 1998 2008
title Horizontal equity in health care utilization in Brazil, 1998 2008
spellingShingle Horizontal equity in health care utilization in Brazil, 1998 2008
Macinko, James
Healthcare
Brazil
Access to care
Primary care
title_short Horizontal equity in health care utilization in Brazil, 1998 2008
title_full Horizontal equity in health care utilization in Brazil, 1998 2008
title_fullStr Horizontal equity in health care utilization in Brazil, 1998 2008
title_full_unstemmed Horizontal equity in health care utilization in Brazil, 1998 2008
title_sort Horizontal equity in health care utilization in Brazil, 1998 2008
author Macinko, James
author_facet Macinko, James
Costa, Maria Fernanda Lima
author_role author
author2 Costa, Maria Fernanda Lima
author2_role author
dc.contributor.author.fl_str_mv Macinko, James
Costa, Maria Fernanda Lima
dc.subject.en.pt_BR.fl_str_mv Healthcare
Brazil
Access to care
Primary care
topic Healthcare
Brazil
Access to care
Primary care
description New York University. Food Studies and Public Health. Department of Nutrition. New York, NY, USA
publishDate 2012
dc.date.issued.fl_str_mv 2012
dc.date.accessioned.fl_str_mv 2014-05-28T18:01:59Z
dc.date.available.fl_str_mv 2014-05-28T18:01:59Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv MACINKO, James; COSTA, Maria Fernanda Lima. Horizontal equity in health care utilization in Brazil, 1998 2008. International Journal for Equity in Health. 2012, vol.11, pp. 33.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/7663
dc.identifier.issn.none.fl_str_mv 1475-927
dc.identifier.doi.none.fl_str_mv 10.1186/1475-9276-11-33
identifier_str_mv MACINKO, James; COSTA, Maria Fernanda Lima. Horizontal equity in health care utilization in Brazil, 1998 2008. International Journal for Equity in Health. 2012, vol.11, pp. 33.
1475-927
10.1186/1475-9276-11-33
url https://www.arca.fiocruz.br/handle/icict/7663
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
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