Dificuldade de acesso a serviços de saúde em idosos comunitários: prevalência e fatores associados

Abstract

Population aging is a phenomenon that occurs on a global scale characterized by an increase in life expectancy and a drop in fertility rate. It has more and more relevance and impact in society and brings with it great repercussions, among them the need for adaptations of the health system to guarantee quality of access to health services by the elderly. The objective of the study was to estimate the prevalence of difficulties in accessing health services among non-institutionalized elderly in the municipality of Montes Claros, MG, Brazil, and to describe the associated factors. This is a cross-sectional study among community elders in Montes Claros, Minas Gerais, Brazil. Data collection was carried out at the household of the elderly between November 2016 and February 2017. Demographic characteristics (sex, age group), social (marital status, family arrangement, schooling and reading) (hypertension, diabetes mellitus, acute myocardial infarction, osteoarticular disease, neoplasia, stroke, self-perception of health, presence of caregiver, decrease in the last 12 months, hospitalization in the last 12 months and frailty). public health system, private care, private practice, special care center, and family health strategy. Bivariate analyzes were carried out ( Pearson's chi-square test), adopting a level of significance lower than 0.20 for inclusion of the independent variables in the multiple model. O The final model was generated by means of Poisson regression analysis, with robust variance, and the variables maintained showed an association with difficulty of using the health services up to the level of significance of 0.05 (p <0.05). A totally of 394 elderly people participated in the study, and the evaluation of the characteristics of the sample showed a predominance of females, 263 (66.8%). The age group with the highest contingent was between 60 and 79 years old 302 (76.6%), with a mean age of 73.9 (SD ± 7.9) years. They lived without partner 199 (50.6%); 295 (74.9%) had up to four years of study. Regarding social variables, 348 (88.3%) elderly did not have a caregiver. Of the clinical variables 281 (71.3%) were hypertensive; 189 (48.0%) reported osteo-articular diseases. Of the elderly evaluated, 33% reported access difficulties. It was verified, in the multiple analysis, greater difficulty of access among the elderly without companion (RP = 1.21); who can not read (PR = 1.23); with negative selfperception of health (PR = 1.13) fragile (PR = 1.35). The elderly faced greater difficulties in access when seeking public services (PR = 1.32). It is concluded that there is a high perception of access difficulty, influenced by social and physical aspects inherent to aging and that can be enhanced by characteristics of public services. There is a need for investments in the health care of the elderly, in order to guarantee the assistance promoting a healthy aging.