Hernandes Elizabeth S C, Lebrão Maria Lúcia, Duarte Yeda A O, Santos Jair L Ferreira
Ministério do Desenvolvimento Social e Combate à Fome, Governo Federal, Brasília, DF, Brasil.
Rev Saude Publica. 2012 Dec;46(6):1030-8.
To examine sociodemographic and epidemiological factors associated with private health insurance coverage in the elderly.
A total of 2,143 individuals aged 60 years or more were interviewed in the city of São Paulo in 2000 and 2006. Having private health insurance was the dichotomous dependent variable. Independent variables included sociodemographic characteristics and self-reported health status. The proportions of the variables studied were described and a logistic regression model considering those variables significant at p < 0.05 was constructed.
The elderly with private insurance coverage had significantly higher income and education. The elderly with no private insurance were screened less for cancer and more for respiratory diseases; they waited longer for appointments; they performed less medical tests; they reported fewer conditions and more falls and had a more negative self-rated health. The insured respondents reported lower vaccination rates and, among those hospitalized, 11.1% had their medical costs covered by the Brazilian National Health System (SUS) in 2000 and 17.9% in 2006. Osteoporosis was the single condition associated with private health insurance.
The elderly with private insurance coverage had significantly higher income and education than those with no private coverage, and these differences were associated with service utilization and social determinants of health.
研究与老年人私人医疗保险覆盖情况相关的社会人口统计学和流行病学因素。
2000年和2006年在圣保罗市共对2143名60岁及以上的个体进行了访谈。拥有私人医疗保险是二分法因变量。自变量包括社会人口统计学特征和自我报告的健康状况。描述了所研究变量的比例，并构建了一个逻辑回归模型，该模型考虑了在p < 0.05时具有显著性的那些变量。
拥有私人医疗保险的老年人收入和受教育程度显著更高。没有私人保险的老年人接受癌症筛查的比例较低，而接受呼吸道疾病筛查的比例较高；他们等待预约的时间更长；他们进行的医学检查较少；他们报告的疾病较少，但跌倒较多，且自我健康评分更负面。参保受访者报告的疫苗接种率较低，在住院患者中，2000年有11.1%的人的医疗费用由巴西国家卫生系统（SUS）支付，2006年这一比例为17.9%。骨质疏松症是与私人医疗保险相关的唯一疾病。
拥有私人医疗保险的老年人比没有私人保险的老年人收入和受教育程度显著更高，这些差异与服务利用和健康的社会决定因素有关。
