[Health care services utilization and access inequalities in the Sao Paulo Metropolitan Region].
This paper presents case study findings in five municipalities in the São Paulo Metropolitan Region. Inequalities in access to health care services and their utilization were described through advanced tabulation data from the 1998 SEADE Life Conditions Survey. The variables analyzed were: owning or not owning private health care insurance, income and age brackets. The health care service attributes studied were: health care services coverage by a health insurance plan, health services demands and average waiting time to receive health care. Compared with other studies, using the 1998 IBGE PNAD, the results allowed us to confirm interregional imbalances which can only be detected in shorter special scale studies: the municipalities. Despite showing the high private health insurances coverage the São Paulo Metropolitan Region has a great inner heterogeneity. The inequalities in private health care insurance, access, waiting time, and type of insurance coverage were observed through income quintiles and age classes analyses. Findings suggest that an expansion of the State's regulation capacity is necessary in order to empower the Brazilian Health Care System principles of universality and equity to be qualified to offer Brazilians the right to access health care services.
Núcleo de Investigação em Serviços e Sistemas de Saúde, Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo, Bela Vista. 01314-000 São Paulo SP.
Umberto Catarino
UC
Pessoto
Luiza Sterman
LS
Heimann
Roberta Cristina
RC
Boaretto
Iracema Ester do Nascimento
IE
Castro
Jorge
J
Kayano
Lauro Cesar
LC
Ibanhes
Virginia
V
Junqueira
Jucilene Leite
JL
da Rocha
Renato
R
Barboza
Carlos Tato
CT
Cortizo
Lourdes da Conceição
Lda C
Martins
Olinda do Carmo
Odo C
Luiz
D001938:Brazil; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D012959:Socioeconomic Factors; D014505:Urban Population