Medicine access and utilization in a population covered by primary health care in Brazil

Andréa Dâmaso Bertoldi, Aluísio Jardim Dornellas de Barros, Anita Wagner, Dennis Ross-Degnan, Pedro Curi Hallal

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)295-302
Number of pages8
JournalHealth Policy
Volume89
Issue number3
DOIs
StatePublished - Mar 2009
Externally publishedYes

Keywords

  • Developing countries
  • Drug utilization
  • Health care quality, access, and evaluation
  • Health expenditures
  • Pharmaceutical policy

ASJC Scopus subject areas

  • Health Policy

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