Use of health services by Brazilian older adults with and without functional limitation
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102017000200302 |
Resumo: | ABSTRACT OBJECTIVE To analyze the use of health services and the quality of medical care received by Brazilian older adults with and without functional limitation. METHODS The main analyses were based on a national sample representing 23,815 participants of the National Survey on Health (PNS) aged 60 years or older. Functional limitation was defined by the difficulty to perform at least one out of ten basic or instrumental activities of daily living. Potential confounding variables included predisposing and enabling factors of the use of health services. RESULTS The prevalence of functional limitation was 30.1% (95%CI 29.2–31.4). The number of doctor visits and hospitalizations in the past 12 months showed statistically significant associations with functional limitation, both for users of the public system (OR = 2.48 [95%CI 2.13–2.88] for three or more doctor visits and OR = 2.58 [95%CI 2.15–3.09] for one or more hospitalizations) and of the private system (OR = 2.56 [95%CI 1.50–4.36] and OR = 2.22 [95%CI 1.64–3.00], respectively). The propensity to use basic health units was higher among users of the private system with functional limitations (OR = 2.01 [95%CI 1.12–3.59]). Only two out of seven indicators of the quality of medical care received were associated with functional limitation, in the perception of users of public and private systems. The public system users with functional limitations did worse evaluation of the freedom for choosing the doctor and waiting time for an appointment, when compared with users of the same system without these limitations (OR = 0.81 [95%CI 0.67–0.99] and OR = 0.76 [95%CI 0.62–0.93], respectively). CONCLUSIONS Older adults with functional limitations use more health services in comparison with those without such limitations. The magnitude of the association between functional limitation and number of doctor visits and hospitalizations was similar in the public and private health systems. |
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Use of health services by Brazilian older adults with and without functional limitationAgedFrail ElderlyDisabled PersonsActivities of Daily LivingHealth Services for the AgedQuality of Health CareABSTRACT OBJECTIVE To analyze the use of health services and the quality of medical care received by Brazilian older adults with and without functional limitation. METHODS The main analyses were based on a national sample representing 23,815 participants of the National Survey on Health (PNS) aged 60 years or older. Functional limitation was defined by the difficulty to perform at least one out of ten basic or instrumental activities of daily living. Potential confounding variables included predisposing and enabling factors of the use of health services. RESULTS The prevalence of functional limitation was 30.1% (95%CI 29.2–31.4). The number of doctor visits and hospitalizations in the past 12 months showed statistically significant associations with functional limitation, both for users of the public system (OR = 2.48 [95%CI 2.13–2.88] for three or more doctor visits and OR = 2.58 [95%CI 2.15–3.09] for one or more hospitalizations) and of the private system (OR = 2.56 [95%CI 1.50–4.36] and OR = 2.22 [95%CI 1.64–3.00], respectively). The propensity to use basic health units was higher among users of the private system with functional limitations (OR = 2.01 [95%CI 1.12–3.59]). Only two out of seven indicators of the quality of medical care received were associated with functional limitation, in the perception of users of public and private systems. The public system users with functional limitations did worse evaluation of the freedom for choosing the doctor and waiting time for an appointment, when compared with users of the same system without these limitations (OR = 0.81 [95%CI 0.67–0.99] and OR = 0.76 [95%CI 0.62–0.93], respectively). CONCLUSIONS Older adults with functional limitations use more health services in comparison with those without such limitations. The magnitude of the association between functional limitation and number of doctor visits and hospitalizations was similar in the public and private health systems.Faculdade de Saúde Pública da Universidade de São Paulo2017-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102017000200302Revista de Saúde Pública v.51 suppl.1 2017reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USP10.1590/s1518-8787.2017051000243info:eu-repo/semantics/openAccessSilva,Alexandre Moreira de MeloMambrini,Juliana Vaz de MeloPeixoto,Sérgio VianaMalta,Deborah CarvalhoLima-Costa,Maria Fernandaeng2017-05-30T00:00:00Zoai:scielo:S0034-89102017000200302Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0034-8910&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.phprevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2017-05-30T00:00Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Use of health services by Brazilian older adults with and without functional limitation |
title |
Use of health services by Brazilian older adults with and without functional limitation |
spellingShingle |
Use of health services by Brazilian older adults with and without functional limitation Silva,Alexandre Moreira de Melo Aged Frail Elderly Disabled Persons Activities of Daily Living Health Services for the Aged Quality of Health Care |
title_short |
Use of health services by Brazilian older adults with and without functional limitation |
title_full |
Use of health services by Brazilian older adults with and without functional limitation |
title_fullStr |
Use of health services by Brazilian older adults with and without functional limitation |
title_full_unstemmed |
Use of health services by Brazilian older adults with and without functional limitation |
title_sort |
Use of health services by Brazilian older adults with and without functional limitation |
author |
Silva,Alexandre Moreira de Melo |
author_facet |
Silva,Alexandre Moreira de Melo Mambrini,Juliana Vaz de Melo Peixoto,Sérgio Viana Malta,Deborah Carvalho Lima-Costa,Maria Fernanda |
author_role |
author |
author2 |
Mambrini,Juliana Vaz de Melo Peixoto,Sérgio Viana Malta,Deborah Carvalho Lima-Costa,Maria Fernanda |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Silva,Alexandre Moreira de Melo Mambrini,Juliana Vaz de Melo Peixoto,Sérgio Viana Malta,Deborah Carvalho Lima-Costa,Maria Fernanda |
dc.subject.por.fl_str_mv |
Aged Frail Elderly Disabled Persons Activities of Daily Living Health Services for the Aged Quality of Health Care |
topic |
Aged Frail Elderly Disabled Persons Activities of Daily Living Health Services for the Aged Quality of Health Care |
description |
ABSTRACT OBJECTIVE To analyze the use of health services and the quality of medical care received by Brazilian older adults with and without functional limitation. METHODS The main analyses were based on a national sample representing 23,815 participants of the National Survey on Health (PNS) aged 60 years or older. Functional limitation was defined by the difficulty to perform at least one out of ten basic or instrumental activities of daily living. Potential confounding variables included predisposing and enabling factors of the use of health services. RESULTS The prevalence of functional limitation was 30.1% (95%CI 29.2–31.4). The number of doctor visits and hospitalizations in the past 12 months showed statistically significant associations with functional limitation, both for users of the public system (OR = 2.48 [95%CI 2.13–2.88] for three or more doctor visits and OR = 2.58 [95%CI 2.15–3.09] for one or more hospitalizations) and of the private system (OR = 2.56 [95%CI 1.50–4.36] and OR = 2.22 [95%CI 1.64–3.00], respectively). The propensity to use basic health units was higher among users of the private system with functional limitations (OR = 2.01 [95%CI 1.12–3.59]). Only two out of seven indicators of the quality of medical care received were associated with functional limitation, in the perception of users of public and private systems. The public system users with functional limitations did worse evaluation of the freedom for choosing the doctor and waiting time for an appointment, when compared with users of the same system without these limitations (OR = 0.81 [95%CI 0.67–0.99] and OR = 0.76 [95%CI 0.62–0.93], respectively). CONCLUSIONS Older adults with functional limitations use more health services in comparison with those without such limitations. The magnitude of the association between functional limitation and number of doctor visits and hospitalizations was similar in the public and private health systems. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102017000200302 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102017000200302 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1518-8787.2017051000243 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
dc.source.none.fl_str_mv |
Revista de Saúde Pública v.51 suppl.1 2017 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1748936504282972160 |