ArticleInternational journal for equity in health2023
Persistent inequalities in health care services utilisation in Brazil (1998-2019).
Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.
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Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Deficiency of B vitamins in women of childbearing age, pregnant, and lactating women in Brazil: a systematic review.Systematic reviews · 2025Pooled it
- Cardiovascular Health Equity: Time for a New Era of Science, Sociology, and Interventions.European heart journal · 2026Article
- Insurance Coverage and Distribution of DXA Screening in Saudi Arabia: Evidence from Major Healthcare Settings.Healthcare (Basel, Switzerland) · 2026Article
- A National Overview of Nutritional Care in Diet-Treated Inborn Errors of Metabolism in Brazil.International journal of environmental research and public health · 2026Article
- Regional inequities in myocardial infarction burden in Brazil's public healthcare system.Archives of public health = Archives belges de sante publique · 2026Article
- Socioeconomic and cardiometabolic factors associated with outpatient healthcare utilization and direct costs in São Paulo, Brazil.BMC public health · 2026Observational
- Psoriasis in the Brazilian Public Health System: A Nationwide Analysis of Healthcare Utilization and Inequalities, 2014-2024.Healthcare (Basel, Switzerland) · 2026Article
- Factors Associated with the Odds, Duration, and Costs of Health-Related Absenteeism: A Population-Based Study in São Paulo City, Brazil.Healthcare (Basel, Switzerland) · 2026Article
- Nationwide decline in psychiatric hospitalizations and costs in Brazil, 2008-2022: a retrospective descriptive study evidencing reform-driven community mental health gains.Lancet regional health. Americas · 2026Article
- Inequities in Dementia Diagnosis: Evidence From the ELSI-Brazil Study.International journal of geriatric psychiatry · 2026Article
- Disparities in breast cancer screening, stage at diagnosis, and treatment in Brazil: a warning of the need to change public policies.BMC public health · 2026Article
- Inequalities in mammograms and cervical biopsies provision in the public and private sectors of the Brazilian healthcare system and the availability of gynecology and obstetrics specialists.Clinics (Sao Paulo, Brazil) · 2026Article
- Association Between Polypharmacy and Socioeconomic and Demographic Factors in Adults Aged 50 Years and Older by Brazilian Macroregions.Pharmacoepidemiology and drug safety · 2026Article
- Unmet Needs in the Care of Patients with Duchenne Muscular Dystrophy in Brazil.Arquivos de neuro-psiquiatria · 2026Observational
- Trauma care in Brazil: a comparative study of patient characteristics at public versus private hospitals.Acta cirurgica brasileira · 2026Article
- Cardiovascular Health Equity: Time for a New Era of Science, Sociology, and Interventions.Global heart · 2026Article
- Income, Geography, and Etiology as Factors Associated with Valve Replacement Outcomes: A Nationwide Cohort of 63,426 Patients in a Middle-Income Country.Global heart · 2026Article
- Inequalities in the use of public oral health services among older adults in Brazil: a national population-based study, 2023.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2026Article
- Association between diagnosis of depression and health service coverage: a multilevel analysis of the National Health Survey, Brazil, 2019.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2026Article
- Regional variation and factors associated with average expenditure per headache disorder hospitalization in Brazil: a macrocosting analysis in the SUS (2008-2023).Revista de saude publica · 2026Observational
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4 authors.
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Abstract
backgroundOne of the primary objectives of the Brazilian health care system is to improve the health and well-being of all citizens. Since the establishment of the Unified Health System/Sistema Único de Saúde (SUS) in 1988, Brazil has made strides towards reducing inequalities in health care services utilisation. However, there are currently no comprehensive and up-to-date studies focused on inequalities in both curative and preventive health care services utilisation.
methodsWe evaluated data from the National Household Sample Survey and the Brazilian National Health Survey, which are two nationally representative studies that include findings from 1998, 2003, and 2008 and 2013 and 2019, respectively. We calculated Erreygers-corrected Concentration Indices (CInds) to evaluate the magnitude of socioeconomic-related inequalities associated with five indicators of health care services utilisation, including physician visits, hospital admissions, surgical procedures, Pap smears, and mammograms. The main factors associated with these inequalities were identified via a decomposition analysis of the calculated CInds.
resultsWhile the results of our analysis revealed persistent inequalities in health care services utilisation that favour the wealthy, we found that the overall magnitude of these inequalities decreased over time. The largest inequalities were observed in the utilisation of preventive care services (Pap smears and mammograms) and services available in the poorest regions of the country. Except for admissions for labour and delivery, our findings revealed that wealthier individuals were more likely to utilise hospital services; this represents a change from findings reported in previous years. Private health insurance coverage and individual socioeconomic status are significantly associated with inequalities in health care services utilisation throughout Brazil.
conclusionsCollectively, our findings suggest that we must continue to monitor potential inequalities in health care service utilisation to determine whether Brazilian policy objectives focused on improved health outcomes for all will ultimately be achieved.
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