Factors associated to medical consultations by elderly adults in southern Brazil: a population based study

Abstract

ABSTRACT:Objective: To analyze the prevalence of medical consultations in the last three months among elderly adults and associated factors. Methods: A cross-sectional, population-based study was carried out with 1,705 elderly adults (60+ years of age) in the urban region of Florianópolis, Santa Catarina, Brazil, in 2009 and 2010. The sampling selection was performed in two stages. The sample was complex, with census tracts as primary and households as secondary sampling units. For association analysis, Poisson regression was performed using predisposing factors, enabling factors and need as independent variables, according to Andersen's theoretical model. Results: The response rate was 89.2%. The prevalence of medical appointments by elderly adults was 70.4% (95%CI = 67.5 -73.4). Factors associated with higher prevalence of medical consultations in the crude analysis were female gender, accumulation of chronic diseases, negative self-perception of health, and report of chronic pain. The multivariate analysis showed that having at least one chronic disease and negative self-perception of health was positively associated with the outcome. Conclusion: Only variables from the need dimension were associated with medical consultations, indicating an equal use of this service.

Fatores associados a não realização de consulta médica nos 12 meses anteriores a entrevista concedida por adultos e idosos em Rio Grande, Rio Grande do Sul, em 2016: estudo transversal*

“…Culturally, male individuals seek specialized care in particular because of the worsening or complication of an already existing clinical condition, 11,17,21 while females (mainly those of childbearing age) seek to have their health monitored over time and for preventive purposes. 11,12,20,[22][23][24] Greater use of health services by females may also be a reflection of how the Brazilian health system is organized, having mother and child health care as one of its priorities. 21,24 With regard to other socio-demographic characteristics, we found that single individuals had fewer medical consultations.…”

“…5,6,12,[20][21][22]24 Higher levels of schooling may be related to more knowledge and positive behaviors with regard to health; these behaviors include greater and more adequate use of health services. 6,20,22,23 Moreover, the literature reveals that individuals with lower levels of income and schooling tend to use the public health system more for medical care, 5,6,25 while those with higher income/schooling use the private health system. 12 Also noteworthy is the fact that family income did not show significant association with the outcome of interest of this article, indicating that difficulties in getting care may possibly be more associated with issues of information and communication 6 than with financial aspects.…”

“…Furthermore, the number of chronic health problems revealed itself to be a determining factor for having medical consultations: the greater the number of health problems, the lower the likelihood of not having had a medical consultation in the last 12 months, reflecting, as expected, greater demand for these consultations. As widely described in the literature, 5,6,11,[19][20][21][22][23] the presence of a health condition that requires medical monitoring increases the probability of using this type of service. According to data collected by the 2013 National Health Survey (PNS), presence of disease was the main motivation for using health services.…”

Factors associated with the frequency of medical consultations by older adults: a national study

“…The change in the age structure in society due to reduced birth rates and increased life expectancy is not always accompanied by changes which ensure decent conditions during aging (1)(2)(3)(4)(5)(6) . The added amount of years lived has contributed to a higher incidence of diseases (7) , especially chronic non--communicable diseases, which contribute to a worsening in functional disability and compromise the quality of life of older adults (6,8) .…”

“…The indicated changes have a direct impact on the increased demand for healthcare (2,5) , regardless of the modality to be taken advantage of and its purpose, with consultations with a medical professional being one of the most recurrent alternatives (4,9) . It is well known that medical appointments are a promising instrument for early diagnosis, preventive action, treatment and necessary guidance.…”