Adult use of health services: A cross-sectional population-based study, Pelotas, Brazil, 2012 and 2021.

Objectives: To compare prevalence of health service use among adults in the urban area of ​​Pelotas in 2012 and 2021 and to assess socioeconomic inequalities in those years. Methods: This was a cross-sectional, population-based study of adults living in the urban area of ​​Pelotas in 2012 and 2021. Unadjusted and adjusted analyses were performed using Poisson regression to assess health service use in the 30 days prior to the surveys, based on sex, age, education, race/skin color, economic class, marital status and self-rated health. The slope index of inequality was used to measure inequalities. Results: The sample consisted of 2,925 participants in 2012 and 5,717 in 2021. Prevalence of health service use increased from 29.3% (95% confidence interval - 95%CI 27.6; 31.1) to 34.4% (95%CI 33.2; 35.6). Among health service users, use of Brazilian Unified Health System facilities increased from 45.7% (95%CI 42.7; 48.7) to 69.8% (95%CI 67.8; 71.7), with a proportional reduction in the use of private services. In 2021, greater dependence on public services was found among women (63.2%), poorer individuals (31.4%) and younger individuals (56.7%). There was an increase in inequalities between economic classes. Conclusion: There was an increase in the use of health services and greater reliance on public services in 2021, especially among socially vulnerable groups. Socioeconomic inequalities widened, reflecting changes in access patterns in the context of the economic and health crises.