Os fatores associados à utilização de serviços preventivos de saúde por idosos em Minas Gerais

Abstract

The epidemiological transition in which the past Brazil has led to a modification of the health profile of the population, gradually replacing infectious diseases to chronic diseases. Allied to this still incomplete transition the country is undergoing a rapid process of population aging. These transitions are given without having found a real change in the quality of life of the majority population. Moreover, the speed of these transitions generated a challenge in terms of institutional capacity, to accommodate the new demands arising from this process. The shift in focus from curative to preventive paradigm was rational to increase the proportion of elderly in a society with increasingly long-lived individuals response, culminating in the implementation of the Programa Saúde da Família (PSF) and prevention programs by private plans health. Given the socioeconomic asymmetries, it is possible that the role of the family is still important to promote the use of preventive care services among the elderly, even in the presence of active pursuits and home care by health professionals of the PSF and incentive programs by health plans. Therefore, it is necessary to understand the role of each of these factors (state, market and family) regarding the use of preventive health services by the elderly. Using data from the Pesquisa de Amostra de Domicílios (PAD) 2011 conducted by João Pinheiro Foundation on preventive services (exams) for seniors applied to a binary multiple logistic model, we analyzed the association between visiting the Community Health Agents (CHA) used as a proxy for the PSF, living arrangement, ownership of the health plan and the likelihood of seniors use preventive health services. Models were estimated for each sex (and for all seniors), and then calculated the probabilities of achieving each of the following screening tests: examination of blood pressure, cholesterol test and glucose test. The mammography, clinical breast exam and Pap test were estimated only for the sample of older women. For elderly living in Minas Gerais, was not found effect of the variables of interest on the chance of the examination of blood pressure. For other tests, those with health insurance were significantly more likely to use the other two tests. The association of the visit of CHA and living arrangement were not statistically significant for women in these two tests. For older men, the living arrangement was statistically significant for both types of arrangement - elderly residing with the spouse and the spouse and child, with the first showing a higher probability than the second, and both exhibited more likely than older residing alone. For elderly men who received a visit from CHA there is a significantly higher probability of use of two other preventive tests compared with those who did not. For exclusive for women exams, health plans have a significant positive association, the only living arrangement for the elderly who co-reside with their spouses, and a visit from CHA only for mammography examination. From these results, it follows that the role of these three factors are critical to the use of preventive health services by the elderly, and the fundamental PSF to resolve socioeconomic differences and the arrangement was crucial to the use of preventive services, especially among elderly men.