71.1% of the persons seek public health care

Most of (71.1%) the 156.1 million Brazilians who seek medical assistance in the same place, by the same doctor or the same type of health service, seek for medical care in the public health system. Out of this total, 47.9% seek assistance in the Basic Health Unit, followed by Emergency Care Units or in Emergency Wards of Public Hospitals (11.3%), in a Public Hospital or Ambulatory Care Unit (10.1%) and Specialty Center, Public Polyclinics or PAM Units (1.8%). Private offices or clinics were reported as the place where 20.6% of the persons used to seek assistance. The private emergency establishments or emergency wards of private hospitals were mentioned by 4.9% of the persons, followed by pharmacies (2.9%).

PNS showed that 71.2% of the Brazilians (142.8 million) had seen a doctor in the 12 months preceding the survey reference date. The North (61.4%), Northeast (66.3%) and Central West (69.5%) recorded smaller percentages in comparison with the national average, whereas the Southeast (75.8%) and South (73.8%) recorded higher estimates. The proportion of persons who had seen a doctor surpassed the national average in the following groups: women (78.0%); white persons (74.8%); persons aged 40 to 59 (73.5%) and aged 60 and over (83.5%) and with higher education (80.4%).

38.8% of the persons who did not manage to get health assistance reported no availability of doctors

According to the PNS, 15.3% of the population (30.7 million) sought some health care in the two weeks preceding the survey reference date. Among those, 97.0% reported having been seen and 95.3% of them, in their first attempt. The most commonly mentioned reasons for seeking health assistance were: illness (33.8%), continued treatment (19.0%), complementary or diagnostic tests (11.9%) and other types of preventive care (8.9%).

The proportion of women (18.5%) who sought assistance was bigger than that of men (11.9%). Attempts at getting health assistance recorded biggest proportions among persons aged 60 and over (25.0%); white (17.0%) and with higher education (18.4%).

Among those who did not receive any assistance in their first attempt, 38.8% said there were no doctors working, and 32.7% did not manage to take a number. The other reasons investigated recorded percentages ranging from 0.5% (persons who could not pay for a medical appointment) to 6.4% (persons who reported lack of specialized health service).

65.7% of the hospitalized persons were assisted by SUS (Unified Health System)

Out of the 200.6 million persons living in Brazil, 6.0% (or 12.1 million persons) had been hospitalized for 24 hours or more in the 12 months preceding the date of the PNS interview. Clinical treatment and surgery were the most usual types of assistance offered to hospitalized patients. In public health establishments, proportions were 42.4% and 24.2%, respectively. In private health establishments, 29.8% and 241.7%, respectively.

In public health establishments, normal births accounted for more hospitalizations (7.2%) than Cesarean deliveries (5.9%). In private health establishments, the opposite took place: Cesarean deliveries (9.7%) surpassed hospitalizations for normal births (2.1%).

Among persons hospitalized for 24 hours or more, 65.7% (or 8.0 million) had received assistance from the Unified Health System (SUS). The Northeast (76.5%) and North (73.9%) Regions recorded the biggest proportions. The proportion of hospitalization in SUS establishments was biggest among persons aged 0 to 17 (75.2%), persons who declared to be black (75.8%) or brown (75.4%), but no differences were recorded in terms of sex. This proportion also increased with the level of instruction: it changed from 80.6% for perrsons without instruction or with unfinished elementary school to 19.7% for persons with complete higher education.

One third of the persons received medicines from the public health system

Among the persons who received medical assistance, in the two weeks preceding the survey reference date, 64.8% (19.3 million) had some of the medicine prescribed and, in this group, 82.5% managed to get all the medicines prescribed, whereas 92.4% managed to get at least one of them.

The proportion of persons who managed to receive from the public health system at least one of the prescribed medicines amounted to 33.2% (or 6.4 million persons). The proportion of brown persons in the aforementioned situation was 36.7%, above the equivalent percentage among white persons (30.2%). This proportion changed from 41.4% for persons without instruction or with incomplete elementary education, to 12.8%, for persons with complete higher education. Out of the estimated total 19.3 million persons who had a medicine prescribed in the latest medical appointment, 21.9% (or 4.2 million) managed to get at least one medicine from the Popular Pharmacy Program; the Northeast Region recorded the smallest proportion (16.4%).

53.4% of the housing units were registered in the Family Health Program

PNS estimated that 56.2% of the Brazilians lived in housing units registered in the Family Health Program, of the Ministry of Health. In the country, they accounted for 53.4% of all the housing units (34.8 million) and the Northeast recorded the biggest proportion (64.7%), whereas the Southeast, the lowest (46.0%). The urban area (50.6%) had a lower proportion than the rural area (70.0%).

Out of the housing units registered in the Program for a year or more (14.2 million), 47.3% were visited by a Health Community Agent ora member of the Family Health Staff every month. The Central West had a result above the national average (58.3%), and the Southeast, the lowest percentage (41.6%). On the other hand, 17.7% had never been visited by a health professional affiliated to the program. In the Southeast, this proportion was 23.8%, whereas in the other region it ranged from 10.8%, in the North and Central West, to 17.8%, in the South.

74.3% of dental services took place in private offices and clinics

In 2013, 67.4% of the persons aged 18 and over evaluated their oral health as good or very good. However, the proportion of persons who had seen a dentist, in the 12 months preceding the survey, was 44.4% (or 89.1 million). The North (34.4%) and Northeast (37.5%) Regions presented the smallest proportions, and the biggest were recorded in the South (51.9%) and Southeast (48.3%).

The proportion of persons who had seen a dentist was bigger among women (47.3%), white persons (50.4%) and in the groups aged 18 to 29 (51.0%) and 30 to 39 (50.4%). Persons aged 60 and over represented the smallest percentage (28.9%). The bigger the level of schooling, the bigger the proportion of visits to the dentist, ranging from 36.6%, for persons without instruction or with incomplete elementary school, to 67.4%, for those with complete higher education.

Dental care in Brazil, in 2013, was mainly present in private offices or clinics, amounting to 74.3% of the appointments. Basic Health Units accounted for 19.6% of the appointments.

Among the adults, 11.0% had lost all their teeth, which corresponds to 16 million Brazilians. This percentage was bigger among women (13.3%) than men (8.4%). Approximately 41.5% of the persons aged 60 and over had lost all their teeth; the same occurred to persons 60 years of age and over without instruction of with incomplete elementary school. The use of dental prosthesis was reported by 28.3% of the male population aged 18 and over, and by 37.9% of the women.

Among persons using health services, 15.5 million reported having been discriminated against

PNS showed that, in 2013, 10.6% of the persons aged 18 and over (or 15.5 million) reported having felt discrimination or having been treated differently from others when using health services, by a doctor or some kind of health professional. The percentages were significantly bigger in the North (13.6%) and Central West (13.3%).

Among those who have felt discriminated by a doctor or another health professional, stand out: women (11.6%); persons aged 30 to 39 (11.9%) and 40 to 59 (12.0%); black (11.9%) and brown (11.4%) persons, and persons without instruction or with incomplete elementary school (11.8%).

The survey also investigated the reasons perceived by persons who felt discriminated in health services. More than one reason was accepted as the answer to this question. More than half of the population aged 18 and over who reported having already felt discriminated in health services presented as reasons lack of money (53.9%) and their social class (52.5%). Discrimination due to lack of money was significantly more commonly felt among men (57.8%) than among women (51.1%).

Reasons like color or race (13.6%), type of occupation (15.6%) and type of disease (14.8%) had relevant percentages of the population who felt discriminated against in health services. Age was a reason for discrimination according to 12.0% of the persons; religion/beliefs, to 8.1%; sex, to 3.7%, and sexual preferences, to 1.7%.

Health insurance was more common among white persons (37.9%) than among brown (18.7%) and black (21.6%) ones

In 2013, 27.9% of the population had medical or dental health insurance. The Southeast (36.9%), South (32.8%) and Central West (30.4%) accounted for the biggest proportions, and the North (13.3%) and Northeast (15.5%), for the lowest ones. In the urban area (31.7%), the percentage of persons with health insurance coverage was about five times that of persons in the rural area (6.2%).

In relation to age groups, persons aged 0 to 17 presented the smallest proportion of health insurance coverage (23.1%), followed by those aged 18 to 29 (26.0%). The groups of persons aged 30 and over presented statistically similar levels, all about 30.0%. It was observed that, the bigger the level of schooling, the bigger the coverage of health insurance, ranging from 16.4% (without instruction or with incomplete elementary school) to 68.8% (complete higher education). In terms of color or race, different proportions were recorded for brown persons (18.7%), black (21.6%) and white (37.9%) ones.

Among those with some kind of health insurance paid directly by the account holder, another resident of the housing unit by a non-resident, 57.6% paid up to R$ 200.00 per month, whereas 4.7% of the persons paid monthly fees of at least R$ 1,000.00 in 2013.

The bigger the benefited group, the bigger the value paid to the health insurance plan. For persons aged 0 to 17, 51.0% paid up to R$ 100.00 per month. This amount was paid by 60.2% of the persons aged 18 to 29 years of age. Among persons 60 and over, 24.2% used to pay up to R$ 100.00, whereas 30.9% paid R$ 500.00 or more per month.

In the population, 5.2% had some kind of health insurance for dental assistance, corresponding to 10.3 million persons. In the group aged 30 to 39, there was the biggest proportion of persons with health insurance for dental assistance (7.3%) and, among those aged 60 and over, the smallest (2.4%).

Integrative and complementary practices were most often used in the North and South

Out of the 200.6 million persons living in the country, 3.8% (or 7.6 million) made use of some type of integrative and complementary practice - treatments such as acupuncture, homeopathy, use of medicinal plants and phytotherapy, among others. Such use was recorded in biggest proportions in the North (5.9%) and South Region (5.2%), and was around the national average in the other regions.

The groups aged 40 to 59 (50%) and 60 and over (5.4%) presented biggest proportions of use of those practices. The proportion of persons with higher education who made use of those practices (7.4%) was bigger that those with other levels of schooling.

A cold or the flu was the main health problem reported as the cause of interruption of daily activities

PNS estimated that 7.0% of the population living in private housing units (or 14.1 million persons) had interrupted usual activities because of health problems in the two weeks preceding the survey. This proportion was biggest among women (8.0%) than men (5.9%), among those without instruction or with incomplete elementary education (8.3%) and among those aged 60 and over (11.5%).

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Among the health problems which prevented the condution of usual activities, 17.8% mentioned a cold or the flu and 10.5%, problems in the neck or nape. The percentage of colds or flu was biggest among persons aged 0 to 17 (38.9%) and decreased with the increase of age (6.9% of the persons 60 years of age and over). Back pain, problems in the neck and nape were proportionally more often observed by persons aged 40 to 59 (16.5%). Other reasons indicated were: pain in the arm or hands, arthritis or rheumatism (5.5%); lesions caused by accident, assault or violence (5.5%); headach or migrained (4.7%); high blood pressure or another heart disease (5.0%); asthma, bronchitis or pneumonia (4.1%); diarrhea, vomit, nausea or gastritis (4.1%) and diabetes, CVA, stroke or cancer (4.1%); and mental problems (4.1%), among others.

A total 20.8 million persons reported having had a dengue fever diagnosis

In 2013, 12.9% of the population (25.8 million persons) reported having had dengue fever once. The proportions were above average in the North (20.5%), Northeast (18.5%) and Central West (17.5%). In the Southeast, 10.8% of the persons reported having had the disease already. The South Region (1.3%) recorded the smallest proportion. The proportions were 13.8% for persons living in the urban area and 7.7% for those in the rural area.

Considering diagnosis by doctors, the percentage of the population who reported dengue fever in Brazil fell to 10.4% (20.8 million persons).

The survey also showed that 69.4% of the housing units (45.2 million were visited by at least one agent from the Endemic Disease Control in the 12 months preceding the date of the interview. The Northeast (78.3%) and Central West (76.5%) recorded the biggest results, whereas the South (50.3%) had the lowest result. Considering the location of the housing units, the urban area (73.5%) had a proportion above that of the rural area (43.7%).

Use of safety belt: 79.4% in the front seat and 50.2% in the back one

The proportion of persons involved in traffic accidents with body wounds in the 12 months preceding the survey in Brazil, was 3.1%. This percentage was bigger among men (4.5%), whereas among women it was 1.8%. The youngest age groups recorded highest percentages, whereas among the oldest, the proportion was smaller. Among persons involved in traffic accidents, 47.2% interrupted usual activities, 15.1% had aftereffects or incapacities.

In Brazil, 79% of the persons aged 18 and over always wore a seat belt in the front seat when in a car, van or taxi. Men and women recorded similar percentages which increased with the level of schooling, ranging from 75.3% This proportion changed from 41.4% of the persons without instruction or with incomplete elementary education, to 12.8%, of persons with complete higher education. In the rural area, this habit was less frequent, with a percentage of 59.1%, whereas the urban area recorded 82.5%. By area, the estimates ranged from 66.0%, in the Northeast, to 86.5%, in the Southeast.

However, the proportion of persons who always wear a seatbelt in the back seat was 50.2%. This percentage increased with the age and was most representative in the urban area (51.1%) than in the rural area (44.8%).

3.1% of the women have been subject to violence by a known person

In Brazil, 3.1% of the persons aged 18 and over were subject to some kind of violence of assault by a known person in the 12 months preceding the date of PNS interview. This proportion was biggest among men (3.7%) than women (2.7%) and decreased with the increase of age. Among the persons who were subject to violence or assault by an unknown person, those without instruction of with incomplete elementary school recorded the lowest percentage (2.0%).

The proportion of persons aged 18 and over who were subject to some violence or assault by a known person in the 12 months prior to the dat of the interview was 2.5%. By area, it was possible to see changes of 2.0% in the Southeast, and 3.2% in the North. This form of violence occurred mainly among women (3.1%), whereas among men the proportion was 1.8%. The persons in the younger age groups were more subject to violence or assault by a known person than those aged 60 and over (1.1%).

The dog population was estimated at 52.2 million, and the cat population, at 22.1 million

In 2013, 44.3% of the housing units had at least one dog, which is equivalent to 28.9 million housing units. The South Region recorded the biggest proportion (58.6%), and the Northeast, the smallest (36.4%). In the rural area, the proportion of housing units with some dog or cat (65.0%) was above that in the urban area (41.0%). The dog population in Brazilian housing units was estimated at 52.2 million, indicating an average of 1.8 dogs per housing unit, considering the housing units with this kind of animal.

In relation to the presence of cats, 17.7% of the houisng units had at least one, equivalent to 11.5 million housing units. The North (22.7%) and Northeast (23.6%) recorded the biggest results, and the Southeast (13.5%) and Central West (14.3%), the lowest. The urban area (14.2%) had a lower proportion compared with the rural area (39.4%). The cat population in Brazilian housing units was estimated at 22.1 million, representing approximately 1.9 cat per housing unit with this animal. 

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Among the housing units with a cat or dog, 75.4% (24.9 million) had all the animals vaccinated against rabies in the 12 months preceding the survey. The Southeast and Central West (84.3% and 81.7%, respectively) presented results above those of the South, North, Northeast Regions (63.5%, 67.1% and 70.1%). Considering the location of the housing unit, the urban area had a proportion above that of the rural area, 79.7% and 58.2%, respectively.