Obesidade e utilização de serviços de saúde e de medicamentos no Brasil: estudo populacional com dados da Pesquisa Nacional de Saúde 2013

• Autor(a) principal: Rimes-Dias, Karina Abibi
• Data de Publicação: 2021
• Outros Autores: [e-mail]
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/17448
• topic: Obesidad; Servicios de Salud; Utilización de Medicamentos; Encuestas Epidemiológicas; Obesity; Health Services; Drug Utilization; Health Surveys; Obesidade; Serviços de saúde; Uso de medicamentos; Inquéritos epidemiológicos; CIENCIAS DA SAUDE::NUTRICAO

Introduction: Obesity is a complex public health problem that is resulting in serious consequences for the world and for Brazil. Evidence about its association with health services use and medication use is still scarce in Brazil. Objective: To analyze the association between obesity and health services use and medication use in Brazil. Methods: Data from the National Health Survey (NHS) 2013, representative of Brazil's population aged 18 or over, were used. The NHS has complex sampling, by three-stage conglomerate (census tracts, households and individuals). The main variables investigated are related to Body Mass Index (BMI), health services use (regular medical assistance, exams, referral/visit to specialized assistance and hospitalization) due to the presence of hypertension and of diabetes, and medication use to treat different groups of chronic diseases associated with obesity: hypertension, diabetes, cardiovascular disease, stroke, arthritis or rheumatism, chronic back pain, depression, lung disease and chronic kidney disease. Weight and height were measured. Descriptive analyzes and multiple regression models were used for data analysis. Results: The products of this thesis consist in two scientific articles. One is about the association of obesity with health services use, and another is about the association of obesity with medication use. Obesity was associated with greater use of all health services investigated, for both sexes. Individuals with obesity used health services approximately twice more than those with normal weight, mainly those related to hypertension, among men; and those related to diabetes, among women. Compared with their eutrophic peers, for example, men with obesity had a higher prevalence of hospitalization due to hypertension (adjusted PR = 2.55; 1.81-3.61), and women with obesity had a higher prevalence of referral/visit to specialist doctor due to diabetes (adjusted PR = 2.56; 1.94-3.38). Obesity was also positively associated with the presence and number of chronic diseases treated with medications. The higher was the BMI, expressed in categories of nutritional status, the greater was medications use to treat at least one chronic disease, with this difference being even greater to treat two or more chronic diseases. Compared to individuals with normal weight, the risk of treating two or more chronic diseases with medication was approximately 160% greater for individuals with class I obesity (adjusted RR = 2.59; 1.96-3.42), 250% greater for those with class II obesity (adjusted RR = 3.49; 2.21-5.51) and 670% greater for those with class III obesity (adjusted RR = 7.70; 4.54-13.04). Conclusions: Individuals with obesity used health services and medications more than individuals with normal weight, that probably result, besides individual consequences, an increase in health expenditures and an overload on the national health system.