Analysis of the evolution and determinants of income-related inequalities in the Brazilian health system, 1998-2008.

Objective. To analyze the evolution and determinants of income-related inequalities in the Brazilian health system between 1998 and 2008. Methods. Data from the National Household Sampling Surveys of 1998, 2003, and 2008 were used to analyze inequalities in health and health care. Health was measure...

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Publicado en:Pan American Journal of Public Health Vol. 33; no. 2; pp. 90 - 98
Autores principales: Almeida, Gisele, Sarti, Flavia Mori, Ferreira, Fernando Fagundes, Diaz, Maria Dolores Montoya, Campino, Antonio Carlos Coelho
Formato: Artículo
Publicado: World Health Organization Feb2013
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2013
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      pub: World Health Organization
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        10.1590/S1020-49892013000200003
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        atl: Analysis of the evolution and determinants of income-related inequalities in the Brazilian health system, 1998-2008.
      aug:
        au:
          Almeida, Gisele
          Sarti, Flavia Mori
          Ferreira, Fernando Fagundes
          Diaz, Maria Dolores Montoya
          Campino, Antonio Carlos Coelho
        affil:
          Pan American Health Organization, Washington, D.C., United States of America
          Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, Brazil
          Faculdade de Economia, Administração e Contabilidade, Universidade de São Paulo, São Paulo, Brazil
      su:
        Brazil
        Dental care
        Health services accessibility
        Health status indicators
        Income
        Health insurance
        Health policy
        Self-evaluation
        Socioeconomic factors
        Educational attainment
        Health equity
        Questionnaires
        Research funding
        Descriptive statistics
      sug:
        subj:
          Dental care
          Health services accessibility
          Health status indicators
          Income
          Health insurance
          Health policy
          Self-evaluation
          Socioeconomic factors
          Educational attainment
          Health equity
          Brazil
          Offices of Dentists
          Dental Equipment and Supplies Manufacturing
          Dental Laboratories
          Direct individual life, health and medical insurance carriers
          Direct group life, health and medical insurance carriers
          Administration of Public Health Programs
          Questionnaires
          Research funding
          Descriptive statistics
      keyword:
        Equity in access
        equity in health
        health policy
        health systems
        Brasil
        Equidad en el acceso
        equidad en salud
        política de salud
        sistemas de salud
        Equity in access
        equity in health
        health policy
        health systems
        Brasil
        Equidad en el acceso
        equidad en salud
        política de salud
        sistemas de salud
      ab: Objective. To analyze the evolution and determinants of income-related inequalities in the Brazilian health system between 1998 and 2008. Methods. Data from the National Household Sampling Surveys of 1998, 2003, and 2008 were used to analyze inequalities in health and health care. Health was measured by self-reported health status, physical limitations, and chronic illness. Hospitalization and physician and dentist visits were proxies for health care utilization. Income was a proxy for socioeconomic status. Concentration indices were calculated before and after standardization for all dependent variables. Decomposition analysis was used to identify the main determinants of inequality in health care utilization. Results. In all three periods analyzed, the poor reported worse health status, while the wealthy reported more chronic diseases; health care utilization was pro-rich for medical and dental services. Yet, income-related inequality in health care utilization has been declining. Private health insurance, education, and income are the major contributors to the inequalities identified. Conclusions. Income-related inequality in the use of medical and dental health care is gradually declining in Brazil. The decline is associated with implementation of pro-equity policies and programs, such as the Community Health Agents Program and the Family Health Program.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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