Outpatient health service utilization and associated factors: a population-based study

Detalhes bibliográficos
Autor(a) principal: Mendoza-Sassi, Raúl Andrés
Data de Publicação: 2003
Outros Autores: Béria, Jorge Umberto, Barros, Aluísio Jardim Dornellas de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FURG (RI FURG)
Texto Completo: http://repositorio.furg.br/handle/1/2648
http://dx.doi.org/10.1590/S0034-89102003000300017
Resumo: Objective To identify factors that lead people to visit a doctor in Brazil and assess differences between socioeconomic groups. Methods A cross-sectional study comprising 1,260 subjects aged 15 or more was carried out in southern Brazil. Demographic, socioeconomic, health needs and regular source of care data were analyzed concerning visits to a doctor within two months from the interview. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression. Results Adjusted PR showed that women having stressful life events, health insurance, and a regular doctor increased the outcome. A dose-related response was found with selfreported health, and the probability of visiting a doctor increased with health needs. Analysis in the chronic disease group revealed that uneducated lower income subjects had a 62% reduction in the chance of visiting a doctor compared to uneducated higher income ones. However, as it was seen a significant interaction between income and education, years of schooling increased utilization in this group. Conclusions Results suggest the existence of health inequity in the poorest group that could be overcome with education. Specific measures reinforcing the importance of having a regular doctor may also improve access in the underserved group.
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spelling Mendoza-Sassi, Raúl AndrésBéria, Jorge UmbertoBarros, Aluísio Jardim Dornellas de2012-10-26T13:57:29Z2012-10-26T13:57:29Z2003MENDOZA-SASSI, Raúl Andrés; BÉRIA, Jorge Umberto; BARROS, Aluísio Jardim Dornelles. Outpatient health service utilization and associated factors: a population-based study. Revista de Saúde Pública, v. 37, n.3, p. 372-378, 2003. Disponível em: <http://www.scielo.br/pdf/rsp/v37n3/15867.pdf>. Acesso em 12 out. 2012.0034-8910http://repositorio.furg.br/handle/1/2648http://dx.doi.org/10.1590/S0034-89102003000300017Objective To identify factors that lead people to visit a doctor in Brazil and assess differences between socioeconomic groups. Methods A cross-sectional study comprising 1,260 subjects aged 15 or more was carried out in southern Brazil. Demographic, socioeconomic, health needs and regular source of care data were analyzed concerning visits to a doctor within two months from the interview. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression. Results Adjusted PR showed that women having stressful life events, health insurance, and a regular doctor increased the outcome. A dose-related response was found with selfreported health, and the probability of visiting a doctor increased with health needs. Analysis in the chronic disease group revealed that uneducated lower income subjects had a 62% reduction in the chance of visiting a doctor compared to uneducated higher income ones. However, as it was seen a significant interaction between income and education, years of schooling increased utilization in this group. Conclusions Results suggest the existence of health inequity in the poorest group that could be overcome with education. Specific measures reinforcing the importance of having a regular doctor may also improve access in the underserved group.Objetivo Identificar os fatores que levam uma pessoa a consultar o médico no Brasil e avaliar as diferenças entre grupos socioeconômicos. Métodos Foi realizado um estudo transversal com 1.260 pessoas de 15 anos ou mais no sul do Brasil. Foram analisados dados demográficos, socioeconômicos, de necessidade em saúde e de fonte definida para consulta quanto a visita ao médico nos últimos dois meses. Foram calculadas as razões ajustadas de prevalência (RP) e os Intervalos de Confiança de 95% (IC 95%), utilizando a regressão de Poisson. Resultados As RP ajustadas mostraram que mulher, eventos estressantes, seguro de saúde e médico de referência aumentaram a probabilidade do desfecho. Foi encontrada uma relação de tipo dose-resposta com auto-avaliação do estado de saúde, e a probabilidade de consultar aumentou a medida que a necessidade em saúde também aumentou. A análise no grupo com doença crônica evidenciou que o grupo de menor renda e sem escolaridade teve uma redução de 62% na probabilidade de visitar o médico em comparação com o grupo de maior renda e sem estudo. Contudo, como ocorreu interação significativa entre renda e educação, o tempo de estudo melhorou a utilização nesse grupo. Conclusões Os resultados sugerem a existência de iniqüidade no grupo mais pobre que pode ser modificada pela educação. Medidas específicas reforçando a importância de ter um médico de referência podem também melhorar o acesso dos mais pobres.engHealth services, utilizationHealth services accessibilityEquity in accessSocioeconomic factorsServiços de saúdeUtilizaçãoAcesso aos serviços de saúdeEqüidade no acessoFatores socioeconômicosOutpatient health service utilization and associated factors: a population-based studyFatores associados à utilização de serviços ambulatoriais: estudo de base populacionalinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FURG (RI FURG)instname:Universidade Federal do Rio Grande (FURG)instacron:FURGORIGINALOutpatient health service utilization and associated factors a population-based study.pdfOutpatient health service utilization and associated factors a population-based study.pdfapplication/pdf165716https://repositorio.furg.br/bitstream/1/2648/1/Outpatient%20health%20service%20utilization%20and%20associated%20factors%20a%20population-based%20study.pdf273aad01ca739c971c2a45f24a95e604MD51open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-81724https://repositorio.furg.br/bitstream/1/2648/2/license.txt5b92b9704b4f13242d70e45ddef35a68MD52open access1/26482013-05-31 17:27:03.67open accessoai:repositorio.furg.br:1/2648w4kgbmVjZXNzw6FyaW8gY29uY29yZGFyIGNvbSBhIGxpY2Vuw6dhIGRlIGRpc3RyaWJ1acOnw6NvIG7Do28tZXhjbHVzaXZhLAphbnRlcyBxdWUgbyBkb2N1bWVudG8gcG9zc2EgYXBhcmVjZXIgbm8gUmVwb3NpdMOzcmlvLiBQb3IgZmF2b3IsIGxlaWEgYQpsaWNlbsOnYSBhdGVudGFtZW50ZS4gQ2FzbyBuZWNlc3NpdGUgZGUgYWxndW0gZXNjbGFyZWNpbWVudG8gZW50cmUgZW0KY29udGF0byBhdHJhdsOpcyBkZTogcmVwb3NpdG9yaW9AZnVyZy5iciBvdSAweHggNTMgMzIzMy02NzA2LgoKTElDRU7Dh0EgREUgRElTVFJJQlVJw4fDg08gTsODTy1FWENMVVNJVkEKCkFvIGFzc2luYXIgZSBlbnRyZWdhciBlc3RhIGxpY2Vuw6dhLCBvL2EgU3IuL1NyYS4gKGF1dG9yIG91IGRldGVudG9yIGRvcyBkaXJlaXRvcyBkZSBhdXRvcik6CgphKSBDb25jZWRlIMOgIFVuaXZlcnNpZGFkZSBGZWRlcmFsIGRlIFJpbyBHcmFuZGUgLSAgRlVSRyBvIGRpcmVpdG8gbsOjby1leGNsdXNpdm8gZGUgcmVwcm9kdXppciwgY29udmVydGVyIChjb21vIGRlZmluaWRvIGFiYWl4byksIGNvbXVuaWNhciBlL291IGRpc3RyaWJ1aXIgbyBkb2N1bWVudG8gZW50cmVndWUgKGluY2x1aW5kbyBvIHJlc3Vtby9hYnN0cmFjdCkgZW0KZm9ybWF0byBkaWdpdGFsIG91IGltcHJlc3NvIGUgZW0gcXVhbHF1ZXIgbWVpby4KCmIpIERlY2xhcmEgcXVlIG8gZG9jdW1lbnRvIGVudHJlZ3VlIMOpIHNldSB0cmFiYWxobyBvcmlnaW5hbCwgZSBxdWUKZGV0w6ltIG8gZGlyZWl0byBkZSBjb25jZWRlciBvcyBkaXJlaXRvcyBjb250aWRvcyBuZXN0YSBsaWNlbsOnYS4gRGVjbGFyYSB0YW1iw6ltIHF1ZSBhIGVudHJlZ2EgZG8gZG9jdW1lbnRvIG7Do28gaW5mcmluZ2UsIHRhbnRvIHF1YW50byBsaGUgw6kgcG9zc8OtdmVsIHNhYmVyLCBvcyBkaXJlaXRvcyBkZSBxdWFscXVlciBvdXRyYSBwZXNzb2Egb3UgZW50aWRhZGUuCgpjKSBTZSBvIGRvY3VtZW50byBlbnRyZWd1ZSBjb250w6ltIG1hdGVyaWFsIGRvIHF1YWwgbsOjbyBkZXTDqW0gb3MKZGlyZWl0b3MgZGUgYXV0b3IsIGRlY2xhcmEgcXVlIG9idGV2ZSBhdXRvcml6YcOnw6NvIGRvIGRldGVudG9yIGRvcwpkaXJlaXRvcyBkZSBhdXRvciBwYXJhIGNvbmNlZGVyIMOgIEZVUkcgb3MgZGlyZWl0b3MgcmVxdWVyaWRvcyBwb3IgZXN0YSBsaWNlbsOnYSwgZSBxdWUgZXNzZSBtYXRlcmlhbCBjdWpvcyBkaXJlaXRvcyBzw6NvIGRlIHRlcmNlaXJvcyBlc3TDoSBjbGFyYW1lbnRlIGlkZW50aWZpY2FkbyBlIHJlY29uaGVjaWRvIG5vIHRleHRvIG91IGNvbnRlw7pkbyBkbyBkb2N1bWVudG8gZW50cmVndWUuCgpTZSBvIGRvY3VtZW50byBlbnRyZWd1ZSDDqSBiYXNlYWRvIGVtIHRyYWJhbGhvIGZpbmFuY2lhZG8gb3UgYXBvaWFkbwpwb3Igb3V0cmEgaW5zdGl0dWnDp8OjbyBxdWUgbsOjbyBhIEZVUkcsIGRlY2xhcmEgcXVlIGN1bXByaXUgcXVhaXNxdWVyIG9icmlnYcOnw7VlcyBleGlnaWRhcyBwZWxvIHJlc3BlY3Rpdm8gY29udHJhdG8gb3UgYWNvcmRvLgoKQSBGVVJHIGlkZW50aWZpY2Fyw6EgY2xhcmFtZW50ZSBvKHMpIHNldSAocykgbm9tZSAocykgY29tbyBvIChzKSBhdXRvciAoZXMpIG91IGRldGVudG9yIChlcykgZG9zIGRpcmVpdG9zIGRvIGRvY3VtZW50byBlbnRyZWd1ZSwgZSBuw6NvIGZhcsOhIHF1YWxxdWVyIGFsdGVyYcOnw6NvLCBwYXJhIGFsw6ltIGRhcyBwZXJtaXRpZGFzIHBvciBlc3RhIGxpY2Vuw6dhLgo=Repositório InstitucionalPUBhttps://repositorio.furg.br/oai/request || http://200.19.254.174/oai/requestopendoar:2013-05-31T20:27:03Repositório Institucional da FURG (RI FURG) - Universidade Federal do Rio Grande (FURG)false
dc.title.pt_BR.fl_str_mv Outpatient health service utilization and associated factors: a population-based study
dc.title.alternative.pt_BR.fl_str_mv Fatores associados à utilização de serviços ambulatoriais: estudo de base populacional
title Outpatient health service utilization and associated factors: a population-based study
spellingShingle Outpatient health service utilization and associated factors: a population-based study
Mendoza-Sassi, Raúl Andrés
Health services, utilization
Health services accessibility
Equity in access
Socioeconomic factors
Serviços de saúde
Utilização
Acesso aos serviços de saúde
Eqüidade no acesso
Fatores socioeconômicos
title_short Outpatient health service utilization and associated factors: a population-based study
title_full Outpatient health service utilization and associated factors: a population-based study
title_fullStr Outpatient health service utilization and associated factors: a population-based study
title_full_unstemmed Outpatient health service utilization and associated factors: a population-based study
title_sort Outpatient health service utilization and associated factors: a population-based study
author Mendoza-Sassi, Raúl Andrés
author_facet Mendoza-Sassi, Raúl Andrés
Béria, Jorge Umberto
Barros, Aluísio Jardim Dornellas de
author_role author
author2 Béria, Jorge Umberto
Barros, Aluísio Jardim Dornellas de
author2_role author
author
dc.contributor.author.fl_str_mv Mendoza-Sassi, Raúl Andrés
Béria, Jorge Umberto
Barros, Aluísio Jardim Dornellas de
dc.subject.por.fl_str_mv Health services, utilization
Health services accessibility
Equity in access
Socioeconomic factors
Serviços de saúde
Utilização
Acesso aos serviços de saúde
Eqüidade no acesso
Fatores socioeconômicos
topic Health services, utilization
Health services accessibility
Equity in access
Socioeconomic factors
Serviços de saúde
Utilização
Acesso aos serviços de saúde
Eqüidade no acesso
Fatores socioeconômicos
description Objective To identify factors that lead people to visit a doctor in Brazil and assess differences between socioeconomic groups. Methods A cross-sectional study comprising 1,260 subjects aged 15 or more was carried out in southern Brazil. Demographic, socioeconomic, health needs and regular source of care data were analyzed concerning visits to a doctor within two months from the interview. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression. Results Adjusted PR showed that women having stressful life events, health insurance, and a regular doctor increased the outcome. A dose-related response was found with selfreported health, and the probability of visiting a doctor increased with health needs. Analysis in the chronic disease group revealed that uneducated lower income subjects had a 62% reduction in the chance of visiting a doctor compared to uneducated higher income ones. However, as it was seen a significant interaction between income and education, years of schooling increased utilization in this group. Conclusions Results suggest the existence of health inequity in the poorest group that could be overcome with education. Specific measures reinforcing the importance of having a regular doctor may also improve access in the underserved group.
publishDate 2003
dc.date.issued.fl_str_mv 2003
dc.date.accessioned.fl_str_mv 2012-10-26T13:57:29Z
dc.date.available.fl_str_mv 2012-10-26T13:57:29Z
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dc.identifier.citation.fl_str_mv MENDOZA-SASSI, Raúl Andrés; BÉRIA, Jorge Umberto; BARROS, Aluísio Jardim Dornelles. Outpatient health service utilization and associated factors: a population-based study. Revista de Saúde Pública, v. 37, n.3, p. 372-378, 2003. Disponível em: <http://www.scielo.br/pdf/rsp/v37n3/15867.pdf>. Acesso em 12 out. 2012.
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dc.identifier.doi.pt_BR.fl_str_mv http://dx.doi.org/10.1590/S0034-89102003000300017
identifier_str_mv MENDOZA-SASSI, Raúl Andrés; BÉRIA, Jorge Umberto; BARROS, Aluísio Jardim Dornelles. Outpatient health service utilization and associated factors: a population-based study. Revista de Saúde Pública, v. 37, n.3, p. 372-378, 2003. Disponível em: <http://www.scielo.br/pdf/rsp/v37n3/15867.pdf>. Acesso em 12 out. 2012.
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