PHP44 - The Ecology of Medical Care in Poor Settings: Self Reported Health Care Utilization in Santiago Del Estero, Argentina

Abstract

Health services utilization in poor provinces in Argentina is poorly known, due to data poor environments. We utilized a population based health care survey to analyzed the ecology of medical care, and to estimate self reported health care services utilization (SRHCU) patterns among adults (≥18 years old). A health Survey was performed, with probabilistic, stratified, polyetapic sampling, adding health utilization questions to the National Risk Factor Survey of Argentina (ENFR 2009) questionnaire. We obtained SRHCU stratified as ambulatory visits, emergency, hospitalizations, stratified into age, sex, rural, urban, health status and prior health problem. Analysis was performed with SPSS 17, 95%CI for single proportions was obtained. Among 2064 persons that responded de survey, 78,9% were urban-21,1% rural, 41,2% males, mean age was 39,9% (SD 15,8) years old, age range 18-93. The General Health Status was regular or bad (16,08%) (95%CI 14,5-17,7%). Likert scale of health status provided Mean = 86,65 (SD 104,35); Median 80 (25P =70; 75P =90). Acute illness events in prior 4 weeks occurred in 24,8% (95%CI 22,9-26,7%). 70,4% had an ambulatory visit in the prior 6 months (95%CI 68,4-72,4%), while, in prior month 17,0% (95%CI 15,4-18,7%) consulted a physician office [generalist 10,36% (95%CI 9,1-11,7%) and 6,7% specialist (95%CI 5,6-7,8%)]. Office visits rate was 261 per 100 persons per year [increased with age 65+ (305), regular or bad health (458), and rurality (289), decreased for males (197)]. Emergency visits occurred in 106 persons (5,1%) (95%CI 4,18-6,09%); Hospitalization was 10,6% during prior year (95%CI 9,3-11,9%), 78% admitted once and 20% readmitted to the hospital in the same period. Results provide an estimate of SRHCU data, and show lower ambulatory and emergency visit rates, while hospitalization admissions and readmissions is similar to other ecology of medical care studies in other areas of the world.