Use of health services by the Brazilian population with chronic kidney disease: a cross-sectional analysis, National Health Survey, 2019.

BACKGROUND

Chronic kidney disease (CKD) is frequently diagnosed at advanced stages, resulting in high morbidity, mortality, and substantial economic burdens due to increased healthcare utilization and system costs. The relationship between CKD diagnosis and healthcare utilization remains unexplored in Brazilian population-based studies. Therefore, this study aimed to analyze the associations between health service utilization indicators and the presence of CKD in the Brazilian population.

METHODS

This was a cross-sectional study with a sample of 90,846 participants from the 2019 National Health Survey. Sociodemographic, clinical, and behavioral variables were collected. CKD was defined by self-reported prior diagnosis. The indicators of use of health services were a search for a health service or professional in the last two weeks, impairment of usual activities due to illness in the last two weeks, and hospitalizations for 24 h or more in the last 12 months. Other variables related to the use of health services, such as having health insurance, the time since the last consultation, and the type of health service most used, were also assessed. Logistic regression analysis was carried out to assess the associations between indicators of health service use and CKD.

RESULTS

CKD increased the chance of hospitalization in the last 12 months by 3.16 times (OR 3.16; 95% CI 2.76-3.62) and the chance of impairment in usual activities due to illness by 3 times (OR 2.99; 95% CI 2.63-3.40). In addition, the presence of CKD increased the chance of the individual seeking health services 2.5 times in the last two weeks (OR 2.50; 95% CI 2.23-2.81), with primary health care (42.5%), private clinics or private outpatient clinics (21.2%) and emergency care units (17.2%) being the most sought-after services.

CONCLUSION

CKD tripled the chance of hospitalization in the last 12 months and impaired usual activities due to illness, doubling the population's search for health services in the last two weeks. Primary health care has proven to be the leading health service for individuals with CKD.