Department of Global Health and Population, Harvard School of Public Health, Harvard University, Boston, MA, USA.
Am J Public Health. 2011 May;101(5):868-74. doi: 10.2105/AJPH.2009.184648. Epub 2010 Aug 19.
We assessed the utilization of home care by the elderly in Brazil after implementation of the Family Health Strategy (FHS).
Data were derived from a cross-sectional study in a southern city in Brazil. Using the χ(2) test and a logistic regression with different levels of determination, we tested the hypothesis that the FHS increased the utilization of home care compared with utilization under the Traditional Primary Health Care (TPHC) system.
We interviewed 1593 residents aged 60 years and older. Home care utilization under the FHS was 2.7 times the rate of utilization under the TPHC (95% confidence interval = 1.5, 4.7; P = .001), and utilization increased among the older group, the less educated, those with history of hospitalization, and those with functional limitations.
Improvement in access to care resulted in greater utilization of home care. Our findings have policy implications that include expanding the coverage of the FHS throughout big cities where coverage is limited. These findings are important because the population is aging and the family strategy operates in poorer areas; thus, it can promote equity in access to home health care among the elderly.
评估家庭健康战略实施后巴西老年人的家庭护理利用情况。
数据来自巴西南部一个城市的横断面研究。使用卡方检验和不同确定水平的逻辑回归，我们检验了家庭健康战略比传统初级卫生保健系统增加家庭护理利用的假设。
我们共访谈了 1593 名 60 岁及以上的居民。家庭健康战略下的家庭护理利用率是传统初级卫生保健系统下利用率的 2.7 倍（95%置信区间为 1.5，4.7；P =.001），而且在年龄较大、教育程度较低、有住院史和功能受限的人群中，利用率有所增加。
改善获得医疗服务的机会导致了家庭护理利用率的增加。我们的发现具有政策意义，包括扩大在覆盖范围有限的大城市的家庭健康战略的覆盖范围。这些发现很重要，因为人口正在老龄化，家庭战略在较贫困地区开展，因此可以促进老年人获得家庭医疗保健的公平性。
