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International Journal for Equity in Health

, 15:150

A panorama of health inequities in Brazil


BackgroundThe Brazilian Unified Health System is a public healthcare system that has universal and equitable access among its main principles, but the continental size of the country and the complexity of the public health system complicate the task of providing equal access to all. We aim to investigate the factors associated with inequities in healthcare utilization in Brazil.

MethodsWe employed data from a nationally representative cross-sectional study 2013 National Health Survey; n = 60,202. The outcome was underutilization of healthcare by adults, defined as lack of utilization of one or more of these services: physician or dentist consultation, and blood glucose or blood pressure screening. A logistic regression model, considering the complex sample, was employed alpha = 5 %.

Results0.7 % of the sample never visited a physician, 3.3 % never visited a dentist, 3 % never underwent blood pressure screening, 11.5 % never underwent blood glucose screening, and 15 % never utilized at least one of these services. Multivariate models showed a higher likelihood of underutilization of healthcare among individuals of the lowest social class -E- AOR = 6.31, 95 % CI = 3.76–10.61, younger adults Adjusted Odds Ratio, or AOR = 4.40, 95 % CI = 3.78–5.12, those with no formal education or incomplete primary education AOR = 2.93, 95 % CI = 2.30–3.74, males AOR = 2.16, 95 % CI = 1.99–2.35, and those without private health insurance AOR = 2.11, 95 % CI = 1.83–2.44. Individuals self-classified as -white- were less likely to report underutilization AOR = 0.82, 95 % CI = 0.75–0.90.

ConclusionsDespite recent expansion of primary healthcare and oral health programs in Brazil, we observed gaps in healthcare utilization among the most vulnerable segments of the population.

KeywordsHealth equity Equity in access Health services accessibility Primary Health Care Unified Health System  Download fulltext PDF

Autor: Cristiano Siqueira Boccolini - Paulo Roberto Borges de Souza Junior


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