Medicine access and utilization in a population covered by primary health care in Brazil.
OBJECTIVE
To describe medicine utilization and access in a population covered by the Family Health Program (PSF) in Brazil.


METHODS
Cross-sectional study with a random sample of 2988 individuals living in areas covered by 45 PSF clinics. Medicine utilization in the 15 days prior to the interview was assessed, as well as lack of access to medicines (proportion of people with medicines needed but not used), and lack of free access through the PSF (proportion of medicines used which had to be purchased).


RESULTS
Overall, 54.5% (95% CI 50.6; 58.4) of individuals used at least one medicine in the 15-day period and 3.6% reported failing to use a needed medicine. Of all medicines used, 41.5% were paid for out-of-pocket (25.5% among the poorest families), and 51.0% were obtained for free from the PSF. Almost 90% of the medicines prescribed by PSF physicians were provided for free by the PSF.


CONCLUSIONS
Although medicine access was high, individuals paid out-of-pocket for a substantial proportion of the medicines used. Lack of availability in PSF facilities and prescribing by non-PSF providers seem to contribute to the need for out-of-pocket purchases, and thus can be targeted for improvement through PSF policies.
Bertoldi
Andréa Dâmaso
AD
Post-graduate Program in Public Health, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil. andreaertoldi@terra.com.br
de Barros
Aluísio Jardim Dornellas
AJ
Wagner
Anita
A
Ross-Degnan
Dennis
D
Hallal
Pedro Curi
PC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations; D011320:Primary Health Care; D055815:Young Adult
D004364:Pharmaceutical Preparations