Social inequalities in care for the elderly with diabetes in Brazil

Revista Panamericana de Salud Pública

Javier Muñiz¹  Teresa Rosalia Pérez Castro¹  Caroline dos Santos Costa²  Rosália Garcia Neves²  Thaynã Ramos Flores²  Andrea Wendt²  Elaine Tomasi²  Fernando César Wehrmeister²  Bruno Pereira Nunes³  Suele Manjourany Silva Duro³ 

[1] Instituto Universitario de Ciencias de la Salud, Universidad da Coruña, A Coruña, España.;Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.;Postgraduate Program in Nursing, Federal Uni­versity of Pelotas, Pelotas, Rio Grande do Sul, Brazil.;

关键词: Diabetes mellitus;    health status disparities;    quality of health care;    quality indicators;    health care;    health services research;    Brazil;   

DOI  :  10.26633/RPSP.2018.88

来源: DOAJ

【 摘 要 】

Objective. To measure the prevalence of various care services offered to the elderly with diabetes mellitus in Brazil, and to assess the social inequalities in these services. Methods. This cross-sectional, population-based study was carried out in 2013. The care services offered were evaluated in terms of the following eight indicators: recommendations to lower carbohydrates, to measure blood glucose, and to examine the feet; requests made for blood tests, for glycated hemoglobin tests, and for glycemic curve tests; and whether service users had had their eyes or feet examined in the previous year. We used the slope index of inequality and the concentration index to assess the inequalities among wealth quintiles. Results. A total of 1 685 elderly persons with diabetes were evaluated. Overall, 41.7% of them had had their eyes examined in the preceding year, 35.4% had had their feet examined in the preceding year, and 10.9% had been offered all eight of the care services. The largest absolute differences (in percentage points) between the first (poorest) and fifth (richest) wealth quintiles in terms of the care services that were offered to the users were for: a recommendation to measure blood glucose (25.8), a glycated hemoglobin test request (27.4), a glycemic curve test request (31.9), having the eyes examined in the preceding year (29.3), and having the feet examined in the preceding year (27.0). Conclusion. There were notable inequalities in the prevalences of the care services. In the future, measurement of blood glucose and examination of the feet should be emphasized, ­especially for elderly persons in a lower socioeconomic level.

【 授权许可】

Unknown