Association between positive assessment of Primary Health Care, sociodemographic characteristics and comorbidities in Brazil

Abstract

To describe positive evaluations of Primary Health Care (PHC) in Brazil from the perspective of users and their association with sociodemographic characteristics and comorbidities. Analysis of the 2019 National Health Survey, in which 9,562 adults responded to the Primary Care Assessment Tool (PCATool). The association between positive PHC assessment (overall score ≥6.6) and individual characteristics was tested using Prevalence Ratios (PR) calculated by Poisson Regression. Less than 40% of Brazilians rated PHC with a high score. Regarding the association of sociodemographic variables with high PHC assessment, adjusted for sex and age, the best PHC assessments were made by women [PRaj 1.10 (95%CI 1.00-1.21)]; elderly (60 years and over) [PRaj 1.27 (95%CI 1.09-1.48); people with a per capita income of 1 to 3 minimum wages (MW) PRaj 1.14 (95%CI 1.03-1.27) and ≥5 MW PRaj 1.75 (95%CI 1.39-2.21) when comparing with income up to 1 MW; residents of the South, Southeast and Midwest regions, compared to the North Region. Considering comorbidities, individuals with hypertension PRaj1,29 (95%CI 1.17-1.43); diabetes PRaj 1.21 (95%CI 1.08-1.36); heart disease PRaj 1.23 (95%CI 1.07-1.41); musculoskeletal disorders PRaj 1.36 (95%CI 1.10-1.69); lung disease PRaj 1.48 (95%CI 1.13-1.95) and obesity PRaj 1.15 (95%CI 1.03-1.28) rated PHC better when compared to normal weight people. Users who evaluate PHC well are usually women, elderly, with high prevalence of chronic non-communicable diseases. A positive evaluation of PHC, in general, results from greater use of health services.