Home Health Care in Brazilian Health System

Thumé, Elaine

Home Health Care in Brazilian Health System

Wednesday, 20 August 2014

Exhibit hall (Dena'ina Center)

Elaine Thumé, PhD , Federal University of Pelotas, Pelotas, Brazil

Luiz A Facchini, PhD , Federal University of Pelotas, Pelotas, Brazil

Elaine Tomasi, PhD , Federal University of Pelotas, Pelotas, Brazil

Bruno P Nunes, MS , Federal University of Pelotas, Pelotas, Brazil

Denise S Silveira, PhD , Federal University of Pelotas, Pelotas, Brazil

Fernando V Siqueira, PhD , Federal University of Pelotas, Pelotas, Brazil

Suele M Silva, PhD , Federal University of Pelotas, Pelotas, Brazil

Aliteia Dilelio, MS , Federal University of Pelotas, Brazil, Pelotas, Brazil

Mariangela U Soares, MD , Federal University of Pelotas, Pelotas, Brazil

Louriele Wachs, MS , Federal University of Pelotas, Pelotas, Brazil

INTRODUCTION: Demand for health care services is rising, yet the capacity of the health system to meet such demand is in question. In Brazil, the Family Health Strategy (FHS) was implemented in 1994 to improve primary health care delivery. The aim was to investigate how many people need home health care (HHC) and the capacity of the health system to delivery care at home.

METHODS: Data from three cross-sectional studies were used. In 2005 it were interviewed 4,003 people 65 years and older living in 41 municipalities (≥ 100,000 inhabitants) in South and Northeast regions. In 2008 the HHC was investigated in a sample of 1,593 elderly aged 60 years and older of Bagé city, and in 2008-2009 data from 6,624 older adults with 60 years and older in 100 municipalities from all Brazilian regions were used.

RESULTS: In 2005, the prevalence of need care in areas covered by FHS was 18% in South and 26% in Northeast, but just 13% received care in South and 21% in Northeast. In the TPHC the prevalence of needed, in South, was 11% and only 3% received HHC, while in Northeast 22% needed and 5% received care. In Bagé, the FHS implementation increased the utilization comparing with TPHC (OR=2.7; 95%CI=1.5-4.8), even after controlling for possible confounders. The HHC was mostly delivered by public services in FHS areas and by private providers in TPHC areas. In 2008-2009 the prevalence of HHC was 12% (95%CI =10.9-12.5) with differences statistically significant (p<0.05) between size of municipality (big cities=7%; small=17%) and social class (rich=7%; poor=14%).

CONCLUSIONS: These findings are important because the FHS operates in poorer areas of the municipalities, thus strengthening its relevance for the promotion of equity.