Access to and use of public and private health services: evidence from a population-based survey in urban brazil
1
Department of Collective Health, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1384
ABSTRACT
ABSTRACT:
BACKGROUND AND
OBJECTIVE:
The coexistence of health care privatization and the Unified Health System (SUS) in Brazil is marked by persistent health inequities and limited evidence on population patterns of health care consumption. This study aims to analyze the profile of access to and utilization of public and private health services in Campinas, identifying sociodemographic inequalities based on data from a large and up-to-date municipal health survey (ISACAMP).
METHODS:
This population-based cross-sectional study analyzed ISACAMP data stratified by socioeconomic areas. Indicators defining profiles were examined across four domains: (1) sociodemographic and economic characteristics; (2) health conditions and perceived needs; (3) access to, utilization of, or lack of access to health services; and (4) knowledge and evaluation of public and private health services. Analyses were conducted in Stata software and interpreted through an intersectionality-informed framework.
RESULTS:
Preliminary results indicate a strong association between health service utilization and coverage type: medical consultation was 2.13 times more prevalent among private health insurance (PHI) holders (PR=2.13; 95% CI: 1.56–2.92). Overall, PHI prevalence was 41.7% (95% CI: 35.8–47.8). Coverage did not differ by sex (p=0.210), but was higher among adults and older adults than adolescents (PR=1.31; 95% CI: 1.10–1.68). Structural disparities were evident: PHI was 1.6 times higher among White individuals compared to Black individuals (49.9% vs 30.5%; PR=1.62; 95% CI: 1.38–1.91) and nearly four times higher among individuals with complete higher education compared to those with no formal education (PR=3.98; 95% CI: 3.22–4.92).
CONCLUSIONS:
Access to and use of health services are strongly associated with private financing, reinforcing persistent inequities. The same population holding PHI is also the one that reported medical consultations in the previous year. Future analyses will map these barriers and identify patterns, strengthening integration between universities, management, and communities by translating data into evidence to support territorial decision-making.
BACKGROUND AND
OBJECTIVE:
The coexistence of health care privatization and the Unified Health System (SUS) in Brazil is marked by persistent health inequities and limited evidence on population patterns of health care consumption. This study aims to analyze the profile of access to and utilization of public and private health services in Campinas, identifying sociodemographic inequalities based on data from a large and up-to-date municipal health survey (ISACAMP).
METHODS:
This population-based cross-sectional study analyzed ISACAMP data stratified by socioeconomic areas. Indicators defining profiles were examined across four domains: (1) sociodemographic and economic characteristics; (2) health conditions and perceived needs; (3) access to, utilization of, or lack of access to health services; and (4) knowledge and evaluation of public and private health services. Analyses were conducted in Stata software and interpreted through an intersectionality-informed framework.
RESULTS:
Preliminary results indicate a strong association between health service utilization and coverage type: medical consultation was 2.13 times more prevalent among private health insurance (PHI) holders (PR=2.13; 95% CI: 1.56–2.92). Overall, PHI prevalence was 41.7% (95% CI: 35.8–47.8). Coverage did not differ by sex (p=0.210), but was higher among adults and older adults than adolescents (PR=1.31; 95% CI: 1.10–1.68). Structural disparities were evident: PHI was 1.6 times higher among White individuals compared to Black individuals (49.9% vs 30.5%; PR=1.62; 95% CI: 1.38–1.91) and nearly four times higher among individuals with complete higher education compared to those with no formal education (PR=3.98; 95% CI: 3.22–4.92).
CONCLUSIONS:
Access to and use of health services are strongly associated with private financing, reinforcing persistent inequities. The same population holding PHI is also the one that reported medical consultations in the previous year. Future analyses will map these barriers and identify patterns, strengthening integration between universities, management, and communities by translating data into evidence to support territorial decision-making.
| eISSN: | 2654-1459 |
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