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Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015

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  • Tais Freire Galvao
  • Gustavo Magno Baldin Tiguman
  • Mónica Caicedo Roa
  • Marcus Tolentino Silva

Abstract

Background Although Brazil has a public and universal healthcare system, utilization of health services is marked by social and regional discrepancies. Objective To assess the prevalence and factors associated with underutilization of healthcare services in the Brazilian Amazon. Method Cross‐sectional, population‐based study. Adults aged over 18 years old were selected through probabilistic sampling. Underutilization of healthcare services was defined as never seeing a physician or a dentist. Poisson regression with robust variance was performed to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). A complex sample design was considered. Results A total of 4001 individuals were included, of which 419 (10.4%; 95% CI, 9.5‐11.4%) never visited a physician or a dentist. In the adjusted analysis, underutilization was higher among poorer people (PR = 3.32; 95% CI, 2.16‐5.11), men (PR = 1.34; 95% CI, 1.10‐1.65), people with brown skin color (Brazilian mixed race; PR = 1.34; 95% CI, 1.02‐1.76), and people who are separated (PR = 1.40; 95% CI, 1.01‐1.94) and widowed (PR = 1.55; 95% CI, 1.02‐2.37), when compared with the reference categories. Individuals with informal jobs, those who are retired, students/housewives, and unemployed people were more vulnerable to underutilization than formal workers (P

Suggested Citation

  • Tais Freire Galvao & Gustavo Magno Baldin Tiguman & Mónica Caicedo Roa & Marcus Tolentino Silva, 2019. "Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1846-1853, October.
    • Handle: RePEc:bla:ijhplm:v:34:y:2019:i:4:p:e1846-e1853
    DOI: 10.1002/hpm.2902
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    References listed on IDEAS

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    1. Fernando José Herkrath & Mario Vianna Vettore & Guilherme Loureiro Werneck, 2018. "Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
    2. Mauricio L Barreto & Davide Rasella & Daiane B Machado & Rosana Aquino & Diana Lima & Leila P Garcia & Alexandra C Boing & Jackson Santos & Juan Escalante & Estela M L Aquino & Claudia Travassos, 2014. "Monitoring and Evaluating Progress towards Universal Health Coverage in Brazil," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-3, September.
    3. Davide Rasella & Sanjay Basu & Thomas Hone & Romulo Paes-Sousa & Carlos Octávio Ocké-Reis & Christopher Millett, 2018. "Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: A nationwide microsimulation study," PLOS Medicine, Public Library of Science, vol. 15(5), pages 1-20, May.
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    1. Fonseca Morello, Thiago, 2023. "Hospitalization due to fire-induced pollution in the Brazilian Amazon: A causal inference analysis with an assessment of policy trade-offs," World Development, Elsevier, vol. 161(C).

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