TY - JOUR
T1 - Medicine access and utilization in a population covered by primary health care in Brazil
AU - Bertoldi, Andréa Dâmaso
AU - de Barros, Aluísio Jardim Dornellas
AU - Wagner, Anita
AU - Ross-Degnan, Dennis
AU - Hallal, Pedro Curi
N1 - Funding Information:
We were funded by the World Bank through the “Reaching the Poor” program. We acknowledge the support provided by the Porto Alegre Secretariat of Health.
PY - 2009/3
Y1 - 2009/3
N2 - Objectives: To describe medicine utilization and access in a population covered by the Family Health Program (PSF) in Brazil. Methods: Cross-sectional study with a random sample of 2988 individuals living in areas covered by 45 PSF clinics. Medicine utilization in the 15 days prior to the interview was assessed, as well as lack of access to medicines (proportion of people with medicines needed but not used), and lack of free access through the PSF (proportion of medicines used which had to be purchased). Results: Overall, 54.5% (95% CI 50.6; 58.4) of individuals used at least one medicine in the 15-day period and 3.6% reported failing to use a needed medicine. Of all medicines used, 41.5% were paid for out-of-pocket (25.5% among the poorest families), and 51.0% were obtained for free from the PSF. Almost 90% of the medicines prescribed by PSF physicians were provided for free by the PSF. Conclusion: Although medicine access was high, individuals paid out-of-pocket for a substantial proportion of the medicines used. Lack of availability in PSF facilities and prescribing by non-PSF providers seem to contribute to the need for out-of-pocket purchases, and thus can be targeted for improvement through PSF policies.
AB - Objectives: To describe medicine utilization and access in a population covered by the Family Health Program (PSF) in Brazil. Methods: Cross-sectional study with a random sample of 2988 individuals living in areas covered by 45 PSF clinics. Medicine utilization in the 15 days prior to the interview was assessed, as well as lack of access to medicines (proportion of people with medicines needed but not used), and lack of free access through the PSF (proportion of medicines used which had to be purchased). Results: Overall, 54.5% (95% CI 50.6; 58.4) of individuals used at least one medicine in the 15-day period and 3.6% reported failing to use a needed medicine. Of all medicines used, 41.5% were paid for out-of-pocket (25.5% among the poorest families), and 51.0% were obtained for free from the PSF. Almost 90% of the medicines prescribed by PSF physicians were provided for free by the PSF. Conclusion: Although medicine access was high, individuals paid out-of-pocket for a substantial proportion of the medicines used. Lack of availability in PSF facilities and prescribing by non-PSF providers seem to contribute to the need for out-of-pocket purchases, and thus can be targeted for improvement through PSF policies.
KW - Developing countries
KW - Drug utilization
KW - Health care quality, access, and evaluation
KW - Health expenditures
KW - Pharmaceutical policy
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U2 - 10.1016/j.healthpol.2008.07.001
DO - 10.1016/j.healthpol.2008.07.001
M3 - Article
C2 - 18722031
AN - SCOPUS:60849113695
SN - 0168-8510
VL - 89
SP - 295
EP - 302
JO - Health Policy
JF - Health Policy
IS - 3
ER -