Montoro Pazzini Watfe Giovana, Fajersztajn Lais, Ribeiro Euler, Rossi Menezes Paulo, Scazufca Marcia
Laboratorio de Investigacao Medica (LIM) 23, Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo SP 05403-903, Brazil.
Instituto de Estudos Avançados da Universidade de São Paulo, São Paulo SP 05508-060, Brazil.
Life (Basel). 2020 Aug 5;10(8):133. doi: 10.3390/life10080133.
In Brazil and in most low- and middle-income countries (LMICs), information about how prepared the health care system is for the rapid aging of the population is scarce. We investigated the prevalence of disability and areas of life affected by disability among elders of the public primary health care in São Paulo and Manaus, Brazil. We investigated whether people with disability visited a primary care professional more frequently, the individual characteristics associated with disability, and differences by city. We randomly selected participants aged ≥60 years ( = 1375). The main outcome was disability, evaluated with the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Exposure variables were consultation with a family physician, sociodemographic characteristics, health status, social support, and lifestyle. The prevalence of global disability was higher in Manaus (66.2% vs. 56.4% in São Paulo). In both cities, participation and mobility were the areas of life most affected by disability. The number of consultations with a family physician was not associated with disability. The high prevalence of disability and associated risk factors indicates that public primary health care is not meeting the needs of elders in both cities. It is warning because most elders in LMICs live in more underserved communities compared to Brazil.
在巴西以及大多数低收入和中等收入国家（LMICs），关于医疗保健系统如何应对人口快速老龄化的信息匮乏。我们调查了巴西圣保罗和马瑙斯公共初级卫生保健机构中老年人的残疾患病率以及受残疾影响的生活领域。我们调查了残疾人士是否更频繁地拜访初级保健专业人员、与残疾相关的个体特征以及不同城市之间的差异。我们随机选取了年龄≥60岁的参与者（n = 1375）。主要结局是残疾，采用12项世界卫生组织残疾评定量表（WHODAS 2.0）进行评估。暴露变量包括与家庭医生的会诊、社会人口学特征、健康状况、社会支持和生活方式。马瑙斯的全球残疾患病率更高（66.2%，而圣保罗为56.4%）。在两个城市中，参与和行动能力是受残疾影响最大的生活领域。与家庭医生的会诊次数与残疾无关。残疾的高患病率及相关风险因素表明，公共初级卫生保健未能满足两个城市中老年人的需求。这令人警醒，因为与巴西相比，大多数低收入和中等收入国家的老年人生活在服务更不足的社区。
