Use of primary care services by elderly people with chronic conditions, Brazil

Abstract

OBJECTIVE: To assess the use of healthcare services by elderly individuals suffering from chronic diseases. METHODS:Cross-sectional study carried out with 2,889 individuals aged 65 years or more with chronic conditions - arterial hypertension, diabetes mellitus and mental illness -, living in catchment areas of primary care units in 41 cities of the South and Northeast regions of Brazil in 2005. The analyzed data were obtained in the baseline study of Programa de Expansão e Consolidação da Saúde da Família (Program for the Expansion and Consolidation of Family Health). The studied variables were sex, age, skin color, marital status, level of schooling, family income, smoking, functional disability, and care model of the primary care unit. The adjusted analysis of outcomes was performed by means of Poisson regression. RESULTS: The prevalence of medical visit in the last six months was 45% in the South region and 46% in the Northeast region. The prevalence of participation in groups of educational activities in the last year was 16% in the South and 22% in the Northeast. In both regions, use of services was higher for elderly people under the age of 80 years, with low level of schooling and living in catchment areas of primary care units with Programa Saúde da Família (Family Health Program). Only in the South region did the elderly with functional disability have higher prevalence of medical visits. CONCLUSIONS: The prevalence of medical visit and participation in groups of educational activities was low when compared to previous studies conducted with elderly individuals in Brazil. The results indicate that, although the Family Health Program promotes greater use of services at primary care units by elderly people with chronic conditions, it is necessary to expand the access of those aged over 80 and of individuals with functional disability.