Viacava Francisco, Porto Silvia Marta, Carvalho Carolina de Campos, Bellido Jaime Gregório
Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Av. Brasil 4365, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2019 Jul 22;24(7):2745-2760. doi: 10.1590/1413-81232018247.15812017.
This article discusses trends in health inequalities and access to health services across the regions of Brazil using data from household surveys conducted between 1998 and 2013. Social inequality was measured based on the ratio between the extremes of years of schooling considering two age groups (18 to 59 years and 60 years and over). The findings show a decline in health status and increase in prevalence of diabetes and hypertension in both age groups, which may be related to the expansion of primary healthcare. The findings regarding the percentage of people who had had a medical appointment in the last 12 months show that low levels of inequalities persist despite a general improvement in access. Despite an increase in the percentage of people with up to 3 years of schooling who had had a dental appointment in the last year, significant inequalities persist. The percentage of people who reported being admitted to hospital in the last 12 months was greater among people with up to 3 years of schooling throughout the study period. The hospitalization rate decreased in both age groups across almost all regions. The proportion of women aged between 50 and 69 years with up to 3 years of schooling who had had a mammogram increased, leading to a decrease in inequality. The findings show the need to ensure the continuity of household surveys to monitor inequalities in access to health care services by region and social group.
本文利用1998年至2013年间进行的家庭调查数据，探讨了巴西各地区健康不平等和获得医疗服务的趋势。社会不平等是根据考虑两个年龄组（18至59岁和60岁及以上）的受教育年限极端值之间的比率来衡量的。研究结果显示，两个年龄组的健康状况均有所下降，糖尿病和高血压患病率有所上升，这可能与初级医疗保健的扩大有关。关于过去12个月内进行过医疗预约的人群百分比的研究结果表明，尽管获得医疗服务的总体情况有所改善，但不平等程度仍然较低。尽管过去一年中接受过3年及以下教育的人群中进行过牙科预约的百分比有所增加，但显著的不平等仍然存在。在整个研究期间，接受过3年及以下教育的人群中，报告在过去12个月内住院的百分比更高。几乎所有地区两个年龄组的住院率均有所下降。接受过3年及以下教育的50至69岁女性进行乳房X光检查的比例有所增加，导致不平等程度下降。研究结果表明，有必要确保家庭调查的连续性，以监测各地区和社会群体在获得医疗服务方面的不平等情况。
