Abstract
To describe the last place of medical and dental health service used in relation to private health plans, and examine the effect of being registered in the primary healthcare system through the Family Health Strategy (FHS). This was a cross-sectional study using data from Brazil's 2008 National Household Survey. Multinomial logistic regression was performed to analyze how a private health plan and enrollment in the FHS influenced the use of health services. Results showed that individuals with a private health plan tend to use medical and dental services more than individuals without such a plan. However, many individuals with a private health plan used public services or paid out-of-pocket services, mainly for dental care. Among individuals without a private plan, being enrolled in the FHS reduced the use of out-of-pocket private services, regardless of age, income or educational level. Enrollment in the FHS increased the chances of using public services, and the effect of this enrollment is greater among those who have a private plan. Policies to strengthen public primary healthcare and to expand the FHS should be encouraged within the universal health system.
Highlights
Universal health coverage (UHC) means that all people can have access to the health services they need, without having to risk financial hardship when paying for them[1]
Among the individuals who visited the dentist in the previous year, 77.1% of the sample did not possess any type of private health plan (PHP), and 11.1% had a PHP with dental coverage
Among those who had a PHP with dentistry, 44% of the individuals visited the dentist through their health plans, 13.9% of the visits were for private services, and 3.6% used public services (Table 1)
Summary
Universal health coverage (UHC) means that all people can have access to the health services they need, without having to risk financial hardship when paying for them[1]. In 2005, all WHO member states made their commitment to ensure UHC, and many advances have been achieved since mainly in relation to the health-related Millennium Development Goals[2]. The coverage of health services and the protection against financial risks are still far from being universal[2]. There are widespread inequalities both in the oral health system[4] and in the use of and access to dental services[5,6]. Universal OHC must overcome certain challenges before it can ensure the availability of equitable, affordable, and accessible oral health services for everyone across the globe[3]
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