Outpatient health service utilization and associated factors: a population-based study.
OBJECTIVE
To identify factors that lead people to visit a doctor in Brazil and assess differences between socioeconomic groups.


METHODS
A cross-sectional study comprising 1,260 subjects aged 15 or more was carried out in southern Brazil. Demographic, socioeconomic, health needs and regular source of care data were analyzed concerning visits to a doctor within two months from the interview. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression.


RESULTS
Adjusted PR showed that women having stressful life events, health insurance, and a regular doctor increased the outcome. A dose-related response was found with self-reported health, and the probability of visiting a doctor increased with health needs. Analysis in the chronic disease group revealed that uneducated lower income subjects had a 62% reduction in the chance of visiting a doctor compared to uneducated higher income ones. However, as it was seen a significant interaction between income and education, years of schooling increased utilization in this group.


CONCLUSIONS
Results suggest the existence of health inequity in the poorest group that could be overcome with education. Specific measures reinforcing the importance of having a regular doctor may also improve access in the underserved group.
Mendoza-Sassi
Raúl
R
Departamento de Medicina Interna, Fundação Universidade Federal do Rio Grande, Rio Grande, RS, Brazil. rams@iname.com
Béria
Jorge U
JU
Barros
Aluísio J D
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001938:Brazil; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012935:Social Justice; D012959:Socioeconomic Factors