Absence of routine medical consultation among hypertensive and/or diabetic elders: an epidemiological study based on the Brazilian National Household Survey 2008

Rev Bras Epidemiol. 2015 Jul-Sep;18(3):578-94. doi: 10.1590/1980-5497201500030005. Epub 2015 Sep 1.
[Article in English, Portuguese]

Abstract

Objective: This exploratory study aimed to investigate the predisposing, enabling and health need characteristics associated with lack of medical visits in the last 12 months, among 23,620 elderly hypertensive and/or diabetic individuals.

Methods: In this research, we used the theoretical behavioral model of Andersen and Newman for use of health services. The data analyzed were produced by the health supplement of the Brazilian National Household Survey (PNAD) 2008, nationwide. To identify the associations, we used the Poisson regression model, which estimates the prevalence ratios and confidence intervals of 95%, considering the significance level of 5%.

Results: The results showed that 10.6% of the study population did not consult the doctor in the period considered, and the prevalence was higher among hypertensive subjects (10.5%) than among diabetic ones (7.1%). The lack of medical consultation was negatively associated with female sex and increasing age (predisposing characteristics), with health insurance coverage (enabling characteristic), worse self-rated health, chronic health conditions selected and the presence of hypertension associated with diabetes (health needs), while the fact of living in the Northeast, North and Midwest appeared positively associated with the event under investigation.

Conclusion: These results corroborate those observed in national and international studies and show evidence of inequality and inequity in the use of medical consultation for this population, based on the findings related to health plan coverage and geographic region.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • Diabetes Mellitus / epidemiology*
  • Family Characteristics
  • Female
  • Health Services
  • Humans
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Referral and Consultation