Benites-Zapata Vicente A, Lozada-Urbano Michelle, Urrunaga-Pastor Diego, Márquez-Bobadilla Edith, Moncada-Mapelli Enrique, Mezones-Holguín Edward
Centro de Investigación en Epidemiologia Clínica y Medicina Basada en Evidencias, Instituto de Investigación, Facultad de Medicina Humana, Universidad de San Martin de Porres. Lima, Perú.
Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia. Lima, Perú.
Rev Peru Med Exp Salud Publica. 2017 Jul-Sep;34(3):478-484. doi: 10.17843/rpmesp.2017.343.2864.
The aim of the study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors using the National Household Survey (ENAHO 2015). The participants were defined as NUHS if they have presented any symptoms, discomfort, illness, relapse of chronic illness or accident during the last month and did not go to the health services. 35036 participants were analyzed; the prevalence of NUHS was 53,9%. NUHS was higher in the coastal region (adjusted Prevalence Ratio [aPR]=1.24;95%CI:1.17-1.31), highlands (aPR=1.38; 95%CI: 1.31-1.46) and jungle (aPR=1.25,95%CI:1.18-1.33) compared to Lima. Likewise, there were a higher prevalence of NUHS in participants without health insurance (aPR=1.59;95%CI:1.52-1.66) and those affiliated to Ministry of Health insurance (aPR=1.16;95%CI:1.11-1.22) compared to those affiliated to Social Security. More than half of the participants suffered from NUHS, which was associated with geographical and health system conditions. It is required evidenced-informed public policies to improve this situation.
该研究的目的是利用全国家庭调查（2015年全国家庭健康调查）评估未使用卫生服务（NUHS）的患病率及其相关因素。如果参与者在过去一个月内出现任何症状、不适、疾病、慢性病复发或事故，但未前往卫生服务机构，则被定义为NUHS。对35036名参与者进行了分析；NUHS的患病率为53.9%。与利马相比，沿海地区（调整患病率比[aPR]=1.24；95%置信区间：1.17-1.31）、高地（aPR=1.38；95%置信区间：1.31-1.46）和丛林地区（aPR=1.25，95%置信区间：1.18-1.33）的NUHS患病率更高。同样，与参加社会保障的参与者相比，没有医疗保险的参与者（aPR=1.59；95%置信区间：1.52-1.66）和参加卫生部保险的参与者（aPR=1.16；95%置信区间：1.11-1.22）的NUHS患病率更高。超过一半的参与者存在未使用卫生服务的情况，这与地理和卫生系统状况有关。需要有循证依据的公共政策来改善这种情况。
