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Orientador(es)
Resumo(s)
O envelhecimento demográfico representa uma grande conquista da humanidade. No
entanto, traz também significativos desafios como, por exemplo, uma maior carga de doenças
e incapacidades, e consequente aumento da utilização dos serviços de saúde.
A utilização dos serviços de saúde é influenciada por determinantes sociais da saúde, entre os
quais o sistema de saúde tem um papel de importante interesse. No Brasil, a assistência à
saúde prestada pelo Sistema Único de Saúde (SUS) é de acesso universal e gratuito. Apesar
disso, quase um terço da população com 60 anos ou mais possui plano de saúde privado o
que, ao permitir dupla entrada no sistema, pode aumentar a desigualdade no acesso aos
serviços.
Este estudo pretendeu investigar se há diferenças na utilização de cuidados de saúde no SUS
entre quem tem e quem não tem plano de saúde privado. Mais especificamente, procurou-se
responder à pergunta: em que medida ter plano de saúde privado por parte das pessoas mais
velhas contribui para desigualdades e afeta a utilização de cuidados de saúde no SUS?
Foi realizada uma análise de dados referentes aos internamentos no SUS, entre 2008 e 2019,
de pessoas com 60 anos ou mais. Foram estudadas duas populações: todos os internamentos
realizados no SUS; e internamentos realizados no SUS de pessoas que possuem plano de saúde
privado.
Os resultados encontrados permitiram identificar importantes diferenças na utilização do SUS
por parte da população com plano de saúde privado: valor médio do internamento superior
àquele da população do SUS; e maior utilização dos serviços para procedimentos com custo mais elevado, como os transplantes, por exemplo. Foram encontradas, ainda, disparidades regionais na população com plano de saúde privado. Residentes no Norte e Centro-Oeste procuraram cuidados de saúde no SUS em regiões distintas da morada de forma mais significativa do que pessoas de outras regiões.
Population ageing represents a great achievement of humanity. However, it also brings significant challenges, such as greater burden of diseases and disabilities and the consequent increase in the use of health services. The use of health services is influenced by social determinants of health, among which the health system plays an important role. In Brazil, health care provided by the Unified Health System (Sistema Único de Saúde – SUS) is universal and free. Nonetheless, almost a third of the population aged 60 years and over has a private health insurance, which, by allowing double entry into the system, can increase inequality in access to the services. This study aimed at investigating whether there are differences in the use of health care in the SUS between those who have and those who do not have a private health insurance. More specifically, it sought to answer the question: to what extent does the possession of private health insurance by older people contribute to inequalities and affect the use of health care in the SUS? Data analysis was performed on hospital admissions registered in the SUS, between 2008 and 2019, of people aged 60 years and over. Two populations were studied: all hospitalizations in the SUS; and hospitalizations in the SUS of people who have a private health insurance. The results found allowed the identification of important differences in the use of the SUS by the population with a private health insurance: a hospitalization avarage value higher than that of the SUS population; and greater use of health services for procedures with higher cost, such as transplants. Regional disparities were also found in the population with private health insurance. North and Central-West residents sought health care in the SUS in regions other than their homes more significantly than people from other regions.
Population ageing represents a great achievement of humanity. However, it also brings significant challenges, such as greater burden of diseases and disabilities and the consequent increase in the use of health services. The use of health services is influenced by social determinants of health, among which the health system plays an important role. In Brazil, health care provided by the Unified Health System (Sistema Único de Saúde – SUS) is universal and free. Nonetheless, almost a third of the population aged 60 years and over has a private health insurance, which, by allowing double entry into the system, can increase inequality in access to the services. This study aimed at investigating whether there are differences in the use of health care in the SUS between those who have and those who do not have a private health insurance. More specifically, it sought to answer the question: to what extent does the possession of private health insurance by older people contribute to inequalities and affect the use of health care in the SUS? Data analysis was performed on hospital admissions registered in the SUS, between 2008 and 2019, of people aged 60 years and over. Two populations were studied: all hospitalizations in the SUS; and hospitalizations in the SUS of people who have a private health insurance. The results found allowed the identification of important differences in the use of the SUS by the population with a private health insurance: a hospitalization avarage value higher than that of the SUS population; and greater use of health services for procedures with higher cost, such as transplants. Regional disparities were also found in the population with private health insurance. North and Central-West residents sought health care in the SUS in regions other than their homes more significantly than people from other regions.
Descrição
Dissertação para obtenção de grau de Mestre em Sociedade, Risco e Saúde
Palavras-chave
Pessoa idosa Sistema de saúde Utilização de serviços de saúde Plano de saúde privado Elderly Health System Health care use Private health insurance
Contexto Educativo
Citação
Editora
Instituto Superior de Ciências Sociais e Políticas
