Acesso e utilização de serviços de saúde por idosos do município de Juiz de Fora – MG

Abstract

Ageing population is a global phenomenon. The new demographic profile increases the need of health services and, consequently, the expansion of its offering. Access depends on establishing and implementing public health policies for the elderly and training the workforce in this field. The impact of population growth on health systems requires the adoption of targeted and more precise measures through efforts to meet the demand of this population. The aim of the present study is to verify the prevalence of access and use of medical consultations and hospitalisations by the elderly in the northern area of the city of Juiz de Fora-MG, as well as the associated factors. This is a cross-sectional study, conducted through a household survey, with a representative sample of the population, consisting of 400 non-institutionalised elderly residents of the northern area of the city, of both genders, aged 60 plus. Data collection was performed between October 2014 and March 2015, using a semistructured questionnaire. Sociodemographic characteristics, health profiles, lifestyles, patterns of access and use of health services by the elderly were analysed. Data were analysed using the software Stata 11.0 and sample weights. The analysis of both outcomes was based on a theoretical determination model, with hierarchical blocks of variables to control potential confounding factors. These blocks were based on Andersen’s behavioural model of health services use, comprising predisposing factors, enabling factors and health needs. Prevalence rates were calculated and Poisson regression was used, considering a 5% significance level. The prevalence of medical consultation use in the last 3 months was 76.5%. Associated with the lower use was: being from the economic classes C/D/E, being of Asian or indigenous races, being vulnerable in terms of fragility, and residing in an area with a traditional primary healthcare unit. Greater use was associated with the participation in educational groups provided by the national health system (SUS). The prevalence of hospitalisation in the last year was 22.9%. Associated with the greater use of this service was: having a caregiver and being from the economic classes C/D/E. Lower use was associated with the 70-79 age group, non-fragile and non-vulnerable. The conclusion is that the elderly studied had access to medical consultation and hospitalisation services, however, it is important to stress the need for greater attention to those of lower economic classes, vulnerable in terms of fragility, of Asian or indigenous races, and those residing in areas with a traditional primary healthcareunit, so that they are ensured equal access to health services.