HEALTH SERVICES UTILIZATION TO IMMUNIZATION AGAINST INFLUENZA AND PNEUMONIA IN DIABETIC POPULATION, SÃO PAULO-BRAZIL
METHODS: Data from two cross-sectional population-based health surveys (ISA-Capital 2003 and ISA-Capital 2008), carried out by home interviews. Using Stata 11, data analysis was carried out by comparison of prevalences at two different periods of time and their 95% confidence intervals. A combined dataset was performed and the difference between the periods was estimated by Chi-squared tests (Rao-Scott) and logistic regression considering the complex sample design of the surveys.
RESULTS: Concerning to immunization against influenza, a significant difference (p<0.001) was found in the period (adults: 15.5% versus elderly: 71.0%). Regarding to immunization against pneumonia, in 2003 immunized adults percentage was 4.5% versus 29.3% in elderly (p=0.015) and in 2008, adults 1.7% versus 24.3% in elderly (p<0.001). Immunization proportion in elderly was 4.1 times (IC95%: 2.4-41.5) higher than in adults, adjusted by sex, schooling and period. For pneumonia, immunization proportion in elderly was 9.4 times (IC95%: 2.1-41.5) higher than in adults, also adjusted as described earlier. Health services utilization for immunization against influenza and pneumonia was predominantly public. In 2003-2008 period, more than 90% of adults used public health services for immunization, despite of it was not found a significant difference in the period.
CONCLUSIONS: Major immunization proportion in elderly may be probably explained by immunization campaigns to the population targeted. Since 2003 until current days, public health service achieves large immunization coverage. National Immunization Program is reference to other countries regarding to immunization coverage through public health system.