Álvares Juliana, Guerra Augusto Afonso, Araújo Vânia Eloisa de, Almeida Alessandra Maciel, Dias Carolina Zampirolli, Ascef Bruna de Oliveira, Costa Ediná Alves, Guibu Ione Aquemi, Soeiro Orlando Mario, Leite Silvana Nair, Karnikowski Margô Gomes de Oliveira, Costa Karen Sarmento, Acurcio Francisco de Assis
Departamento de Ciências Farmacêuticas. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil.
Pontifícia Universidade Católica de Minas Gerais. Belo Horizonte, MG, Brasil.
Rev Saude Publica. 2017 Nov 13;51(suppl 2):20s. doi: 10.11606/S1518-8787.2017051007139.
To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients' perspective.
This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Services, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators.
For the "availability" dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For "accessibility," 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For "accommodation," UBS was evaluated as very good/good for the items "comfort" (74.2%) and "cleanliness" (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For "acceptability," 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units' service was very good/good. For "affordability," 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines.
Results show 70%-90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population.
从患者角度评估巴西统一卫生系统（SUS）初级卫生保健中的药品可及性。
这是一项横断面研究，使用了2015年全国药品获取、使用及合理用药促进调查 - 服务（PNAUM - 全国药品获取、使用及合理用药促进调查）的数据，该调查通过对巴西五个地区城市的8591名患者进行访谈开展。根据彭尚斯基和托马斯（1981年）提出的概念，从可获得性、可及性、便利性、可接受性和可负担性维度评估药品可及性。每个维度由各自的指标进行评估。
对于“可获得性”维度，59.8%的患者报告能够完全获得药品，各地区之间无显著差异。对于“可及性”，60%的患者称基本卫生单位（UBS）离他们家不远，83%的患者表示前往UBS非常容易/容易，且大多数患者报告是步行前往（64.5%）。对于“便利性”，UBS在“舒适度”（74.2%）和“清洁度”（90.9%）项目上被评为非常好/好，70.8%的患者报告他们取药时无需等待，尽管平均等待时间为32.9分钟。对于“可接受性”，93.1%的患者报告配药单位工作人员服务尊重且礼貌，90.5%的患者称单位服务非常好/好。对于“可负担性”，13%的患者报告无力购买用于支付健康问题费用的重要物品，41.8%的参与者指出药品费用问题。
结果显示符合率为70% - 90%，与发达国家相当。然而，药品可及性仍然是一项挑战，因为公共卫生单位基本药物供应不足仍严重影响可及性，表明药品可及性对民众而言并非普遍、平等且果断地得以实现。
