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Tempo de espera, distância e transporte: equidade e desigualdade no acesso aos cuidados de saúde pelo utente hipertenso em Portugal
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RESUMO - Introdução: Ao longo dos anos, diversos estudos têm reforçado a premissa de que os
fatores socioeconómicos de um individuo, afetam de forma positiva ou negativa o seu
acesso aos cuidados de saúde, podendo prolongar ou diminuir o seu tempo de espera.
O objetivo do presente trabalho de investigação foi realizar uma análise da equidade e
desigualdade no acesso aos cuidados de saúde, no contexto dos tempos de espera,
entre utentes adultos e idosos hipertensos em Portugal.
Metodologia: Realizou-se um estudo observacional, transversal, analítico com recolha
de informação retrospetiva tendo por base os dados recolhidos através do Inquérito
Nacional de Saúde de 2019, realizado pelo Instituto Nacional de Estatística. Foram
selecionados para análise, todos os participantes residentes em Portugal com idade
igual ou superior a 18 anos que sejam hipertensos.
Resultados: Foram analisados os dados recolhidos de 4471 participantes no Inquérito
Nacional de Saúde de 2019, residentes em Portugal. Após a realização da análise
bivariável e análise multivariável, verificou-se que variáveis socioeconómicas como o
nível de rendimento, onde os indivíduos do 4º (OR=0,722; p=0,026) e 5º quintil
(OR=0,607; p=0,008), tendem a reportar um menor tempo de espera quando
comparados com os restantes escalões de rendimento. Estes dois escalões de
rendimento surgem novamente como fatores protetores quanto à fundamentação da sua
espera, não atribuindo à distância ou acesso a transportes como causa da sua espera.
Conclusões: Apesar de existirem diversos estudos nacionais e internacionais de anos
passados, que apontam para conclusões semelhantes. Podemos verificar que apesar
das medidas tomadas e da universalidade do Serviço Nacional de Saúde, continuamos
a verificar que as variáveis socioeconómicas desempenham ainda um papel no acesso
aos cuidados de saúde dos adultos e idosos hipertensos, potenciando iniquidades no
acesso aos cuidados de saúde nesta população.
Torna-se assim imperativo o desenvolvimento deste tipo de estudos não só para utentes
portadores de hipertensão arterial, mas também para com outras morbilidades e
patologias, beneficiando desta tipologia de análise.
ABSTRACT - Introduction: Over the years, several studies have reinforced the premise that an individual's socioeconomic factors can positively or negatively affect their access to health care, extending or reducing their waiting time. The aim of this research work was to carry out an analysis of equity and inequality in health care access, in the context of waiting times, among hypertensive adult and elderly patients in Portugal. Methodology: An observational, cross-sectional, analytical study was carried out with the collection of retrospective information based on data collected through the 2019 National Health Survey, carried out by the Instituto Nacional de Estatística. All participants selected for the analysis resided in Portugal, had an age equal to or over 18 years and were suffering from arterial hypertension. Results: Data collected from 4471 participants in the 2019 National Health Survey, residing in Portugal, were analyzed. After performing the bivariate analysis and multivariate analysis, it was found that socioeconomic variables such as income level, where individuals in the 4th (OR=0.722; p=0.026) and 5th quintile (OR=0.607; p=0.008) tend to report a shorter waiting time when compared to the other income brackets. These two income brackets appear again as protective factors regarding the basis for their waiting, not attributing distance or access to transport as the cause of their waiting. Conclusions: Although there are several national and international studies from past years that point to similar conclusions. We can see that despite the measures taken and the universality of the National Health Service, we continue to see that socioeconomic variables still play a role in the access to health care of hypertensive adults and elderly people, increasing inequities in access to health care in this population. Therefore, it is imperative to develop this type of study, not only for patients with arterial hypertension, but also with other morbidities and pathologies, benefiting from this type of analysis.
ABSTRACT - Introduction: Over the years, several studies have reinforced the premise that an individual's socioeconomic factors can positively or negatively affect their access to health care, extending or reducing their waiting time. The aim of this research work was to carry out an analysis of equity and inequality in health care access, in the context of waiting times, among hypertensive adult and elderly patients in Portugal. Methodology: An observational, cross-sectional, analytical study was carried out with the collection of retrospective information based on data collected through the 2019 National Health Survey, carried out by the Instituto Nacional de Estatística. All participants selected for the analysis resided in Portugal, had an age equal to or over 18 years and were suffering from arterial hypertension. Results: Data collected from 4471 participants in the 2019 National Health Survey, residing in Portugal, were analyzed. After performing the bivariate analysis and multivariate analysis, it was found that socioeconomic variables such as income level, where individuals in the 4th (OR=0.722; p=0.026) and 5th quintile (OR=0.607; p=0.008) tend to report a shorter waiting time when compared to the other income brackets. These two income brackets appear again as protective factors regarding the basis for their waiting, not attributing distance or access to transport as the cause of their waiting. Conclusions: Although there are several national and international studies from past years that point to similar conclusions. We can see that despite the measures taken and the universality of the National Health Service, we continue to see that socioeconomic variables still play a role in the access to health care of hypertensive adults and elderly people, increasing inequities in access to health care in this population. Therefore, it is imperative to develop this type of study, not only for patients with arterial hypertension, but also with other morbidities and pathologies, benefiting from this type of analysis.
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Palavras-chave
Acesso Equidade Desigualdade Tempo de espera Distância Transportes Hipertensão Arterial Access Equity Inequality Waiting time Distance Transportation Arterial hypertension