Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil.

Deborah Carvalho Malta,Regina Tomie Ivata Bernal,Silvânia Suely Caribé De Araújo,Marilisa Berti De Azevedo Barros,Marta Maria Alves Da Silva,Margareth Guimarães Lima,Maria Imaculada De Fátima Freitas

doi:10.1590/s1518-8787.2017051000090

Abstract

ABSTRACTOBJECTIVE To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD).METHODS Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals.RESULTS The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53–1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78–3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24–1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.CONCLUSIONS NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.

Highlights

IntroductionNoncommunicable diseases (NCD) (cardiovascular diseases, chronic respiratory diseases, diabetes, and cancers) are responsible for about 70% of all deaths worldwide – around 38 million deaths annually
Noncommunicable diseases (NCD) are responsible for about 70% of all deaths worldwide – around 38 million deaths annually
This study aims to assess whether sex, education level, and health insurance affect health services use among the adult Brazilian population with NCD

Summary

Introduction

Noncommunicable diseases (NCD) (cardiovascular diseases, chronic respiratory diseases, diabetes, and cancers) are responsible for about 70% of all deaths worldwide – around 38 million deaths annually. 16 million deaths occur prematurely (people under 70 years of age) and nearly 28 million in low-and middle-income countriesa,b. Intervention in the risk factors would result in the reduction of the number of deaths around the worlda,b,c. An epidemic of NCD results in devastating consequences for individuals, families, and communities, and it overloads health systemsa,b. Studies show that NCDs are more likely to affect low-income populations, as they are more vulnerable and more exposed to the risk factor, as well as having less access to health services and health promotion and disease prevention practices2,a. The World Health Organization (WHO) estimates that people with NCD have their poverty exacerbated by the largest family spending due to the disease, seeking of services, among others2,b

Methods

Results

Discussion

Conclusion