Primary care and healthcare utilization among older Brazilians (ELSI-Brazil)

Autores

  • James Macinko UCLA. Fielding School of Public Health. Departments of Health Policy and Management and Community Health Sciences
  • Fabíola Bof de Andrade Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva
  • Paulo Roberto Borges de Souza Junior Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde
  • Maria Fernanda Lima-Costa Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva

DOI:

https://doi.org/10.11606/s1518-8787.2018052000595

Palavras-chave:

Aged, Health Services for the Aged, Health Services, Needs and Demand, Primary Health Care

Resumo

OBJECTIVE: To characterize healthcare access and utilization among older Brazilians. METHODS: Data are from the baseline wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is a nationally representative, population-based cohort study of persons aged 50 years and older conducted in 2015/2016 (n = 9,412). The prevalence of barriers to primary care and number and type of doctor visits in the past 12 months are compared by three main sources of healthcare (private, Family Health Strategy, traditional public clinics). Two-part multivariable hurdle analyses assess the relation between healthcare utilization, primary care problems, and source of healthcare, while controlling for healthcare determinants. RESULTS: Females comprised 54% of the sample, with a mean age of 63 years. There were no demographic differences by source of healthcare. Nearly 83% had at least one doctor visit in the past 12 months, with higher use among private health plan holders. Private health plan holders most frequently visited specialists, while those using the public system were more likely to visit a general practitioner. Primary care barriers averaged 3.5 out of 12 and were the highest among those using traditional health posts. A greater number of primary care problems was negatively associated with all types of healthcare utilization. CONCLUSIONS: By international standards, access to basic healthcare among older Brazilians is relatively high. Nevertheless, different levels of primary care problems between the public and private sectors and resulting utilization patterns suggest the need to continue working to close remaining gaps.

Publicado

2019-01-24

Edição

Seção

Artigos Originais

Como Citar

Macinko, J., Andrade, F. B. de, Souza Junior, P. R. B. de, & Lima-Costa, M. F. (2019). Primary care and healthcare utilization among older Brazilians (ELSI-Brazil). Revista De Saúde Pública, 52(Suppl 2), 6s. https://doi.org/10.11606/s1518-8787.2018052000595