Utilization of health services by children under five years old in Brazil: prevalence and associated factors

Tomasi, Elaine

Utilization of health services by children under five years old in Brazil: prevalence and associated factors

Wednesday, 20 August 2014

Exhibit hall (Dena'ina Center)

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

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

Elaine Thumé, PhD , 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

Meryene Bordon, MS , Federal University of Pelotas, Pelotas, Brazil

Mirelle O Saes, MS , Federal University of Pelotas, Pelotas, Brazil

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

INTRODUCTION: In addition to the morbidity profile of children, the patterns of health services utilization by this group may be of great using to planning and improvement of the health system. The objective was to describe the utilization of health services in a sample of Brazilian children aged less than five years and investigate the associated factors.

METHODS: A cross-sectional study performed in 2009 in 100 municipalities with different population size in 23 Federal Units of the five Brazilian geopolitical areas identified 6,360 urban children through a multilevel sample process. It was investigated the utilization of four kinds of health services: home health care, medical consultation - in the last three months, and the use of emergency room and hospital admissions - in the last year. The data were analyzed through Poisson regression, using 5% significance level.

RESULTS: About 54% of the children visited a physician during the past three months (CI95% 52,8-55,2) and 8,0% (CI95% 7,3 - 8,7) received home health care. Around 33% of the children were attended in emergency services (CI95% 32,7-35,0) and 10,7% (CI95% 10,0-11,5) was hospitalized in the 12 previous months. After adjustments, the girls were less hospitalized (p=0,022) and presented a lower utilization of emergency services (p=0,010) than boys. The prevalence of home health care (p<0,001) and medical consultation (p<0,001) decreased with age. Compared to the poorer ones (D and E classes), the richer had less home care (p<0,001), more medical consultation (p<0,001) and more emergency services attendance (p<0,001).

CONCLUSIONS: Despite the improvement in the access to health services in Brazil, its utilization by children still present significant inequalities.