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Access to Primary Health Care by older adults from rural areas in Southern Brazil

  • Ferreira, Luiza Santos1
  • Moreira, Laísa Rodrigues2
  • Paludo, Simone dos Santos3
  • Meucci, Rodrigo Dalke4
  • 1 Universidade Federal do Rio Grande. Faculdade de Medicina. Programa de Pós-Graduação em Saúde Pública. Rio Grande, RS, Brasil, Rio Grande RS , (Brazil)
  • 2 Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil, Pelotas RS , (Brazil)
  • 3 Universidade Federal do Rio Grande. Instituto de Ciências Humanas e da Informação. Rio Grande, RS, Brasil, Rio Grande RS , (Brazil)
  • 4 Universidade Federal do Rio Grande. Faculdade de Medicina. Rio Grande, RS, Brasil, Rio Grande RS , (Brazil)
Published Article
Revista de Saúde Pública
Universidade de Sao Paulo Sistema Integrado de Bibliotecas - SIBiUSP
Publication Date
Dec 04, 2020
DOI: 10.11606/s1518-8787.2020054002316
PMID: 33331492
PMCID: PMC7726917
PubMed Central


OBJECTIVE To characterize the access and use of health services considered reference among the older rural population from a municipality in southern Brazil, whose rural area has full coverage of the Family Health Strategy (FHS), investigating factors associated with the choice of the Basic Family Health Unit (BFHU) as reference. METHODS This is a cross-sectional study conducted in 2017 with systematic sampling of rural households in the municipality of Rio Grande (RS) using a standardized in-house questionnaire. We performed descriptive analyses of sociodemographic profile, type of reference service chosen, and reasons for choosing/using the prime-choice service and the nearest BFHU. Poisson regression was used to investigate factors associated with the type of reference service chosen. RESULTS Among the 1,030 older adults who participated in the study, 61.4% considered the BFHU a prime choice/reference service mostly due to its proximity (82.6%); the others sought other places due to a greater ease (34.6%) and resoluteness (52.6%). Almost ⅔ of the respondents sought care at the BFHU during the last year, and the reasons differed among those who considered the unit as reference (chronic disease) and those who sought another place (procedures). We also found that the lower the age, income, education, and household-unit distance, the greater the likelihood of the older adult considering the nearest BFHU as reference service. CONCLUSIONS The FHS has reached the vulnerable older rural population, approaching an equitable public health system. However, further evaluations are necessary to verify the quality and adequacy of care, given that social structure, enabling factors (such as economic condition), and possible beliefs regarding health still establish the standards for choosing a service.

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