Utilização de serviços públicos e privados de saúde, segundo inquérito telefônico na população de Belo Horizonte, 2009

Abstract

The aim of this study was to analyze the utilization of public and private health services byresidents of the City of Belo Horizonte, Minas Gerais, Brazil. Telephonic interviews wereconducted with adult subjects (. 18 years old), residing in Belo Horizonte, who participatedin Vigilancia de Fatores de Risco e Protecao para Doencas Cronicas por InqueritoTelefonico (VIGITEL - Telephone-based Surveillance of Risk and Protective Factors forChronic Diseases), in 2009. Two separate questionnaires were administered in the samepopulation (n = 288): the first by the Brazilian Ministry of Health, and second, by UFMG, onaccess, utilization and evaluation of health services, forming a single database. The dataanalysis was performed with the use of weighted factors to correct, at least partially, bias inthe estimates for the population living in Belo Horizonte, determined by a non-universaltelephone network coverage. The characterization of the sample was performed by calculatingthe absolute and relative frequencies and their confidence intervals of 95% according to userclassification of health services exclusively on the Sistema Unico de Saude (SUS) - BrazilianHealth System - or beneficiary of the Supplemental Health (SH). Statistical differences wereevaluated using the chi-square test or Fisher exact test. We considered the statisticalsignificance level of 5% (p<0.05). The results of this study showed demographic differencesbetween the unique users of the SUS and the recipients of the SH in Belo Horizonte. The SUSunique users had less education, were younger, unmarried and non-white. Recipients of SHwere better educated, were older, married and Caucasian. Furthermore, both plans same needand demand for health services in the last two weeks prior to the study, but, customer servicewas greater among recipients of SH. Another result of note was Also of interest was theconsolidation of primary care as the first level for assistance by SUS health care users at theexpense of increased demand for secondary and tertiary sectors among the beneficiaries ofSH. According to procurement of health services by users, there was equality in radiologicalexams, laboratory check-up in less than one year, vaccine use and to regular, in-home visitsby health workers. Moreover, SUS users were referred more frequently for consultations tospecialists and other complex health services. Finally, both plan users demonstrated similarknowledge about SUS, Family Health Program and the positive evaluation of care received.In conclusion, there were inequities in access and utilization of health services among theunique users of SUS and recipients of SH. However, services providing vaccines and healthagents proved universal and comprehensive access to the entire population. Primary care isconsolidated as a gateway to health services by SUS plan users The exams and screening andcheck-ups in less than 1 year were similar for both groups. The service received waspositively evaluated independently of the funding system.