Diabetes, hypertension, cancer, spinal column problems and rheumatism are among the chronic diseases which affected 52.6 million Brazilians in 2003. The total, which represents 29.9% of the population , included 22.1 million men and 30.5 million women...

Diabetes, hypertension, cancer, spinal column problems and rheumatism are among the chronic diseases which affected 52.6 million Brazilians in 2003. The total, which represents 29.9% of the population , included 22.1 million men and 30.5 million women, being 9.7 million the number of people who suffered from three or more chronic diseases. In 2003, 43.2 million Brazilians had some kind of health insurance.

These are some of the data provided by PNAD 2003 (National Household Sample Survey - 2003) from IBGE, in which over 133 thousand dwellings were visited and 384.8 thousand people interviewed.

The survey also investigated how Brazilians rate their own health conditions – 78.6% considered it Very Good and Good. It was also observed that 62.8% of the population had seen a doctor at most a year before the survey, and 15.9% had never been to the dentist’s, a percentage smaller than that observed in 1998 (18.7%).

In 2003, PNAD also investigated the occurrence of three preventive examinations (clinical breast examination, Pap test and mammography) and showed that 34.4% of the Brazilian women over 40 had never undergone clinical breast examination.

It was estimated, in 2003, that about 78.6% of the 176 million Brazilians rated their health conditions as Good or Very Good, and 3.4% as Poor and Very Poor. Male patients (81.0%) had a higher level of satisfaction with health services than female ones (76.3%).

Among informants up to 13 years old, the level of satisfaction was the same – about 91.0% – for both sexes. Among informants over 14 years of age, women presented, invariably, lower levels of satisfaction. Satisfaction also varied according to informants’ income: 72.7% for those who earned up to a minimum wage, 91.6% for those who earned over 20 minimum wages.

Almost 30% of Brazilians suffer from chronic diseases

PNAD 2003 estimated that 29.9% of the Brazilian population suffered from some kind of chronic disease such as diabetes, rheumatism, hypertension, cancer, tuberculosis, cardiopathies and spinal column problems, among others. By sex, the percentages were: women (33.9%) and men (25.7%). In 1998, this estimate had reached 31.6% of the population. The proportion of people suffering from chronic diseases increased with age: ranging from 9.1% for age group 0-4 to 77.6%, for patients 65 years of age or over.

Out of the 52.6 million people who declared to suffer from chronic diseases that had been diagnosed by a health professional, 18.5% ( 9.7 million) had been affected by three or more diseases.

It was also observed that, in the two weeks prior to the survey, 6.9% of the people interviewed had to reduce their activities due to health problems. Once more, women (7.6%) outnumbered men (6.1%). On average, the reduction lasted 5.4 days, and men stayed away from their activities longer than women.

Health services were considered Very Good and Good by 86% of patients

The survey showed that 25.7 million people, that is, 14.6% of the population, sought medical treatment at a certain moment in the period of 15 days preceding the survey. Most of those patients were members of extreme age groups. Among these patients, 13.1 million sought medical treatment because of illnesses and 7.2 million in order to be vaccinated or have other kinds of preventive treatments.

Over half of the medical appointments in the period considered in the survey (57.2%) were under the responsibility of the National Health System (SUS) and 26.0% of them had complete or partial participation of health insurance plans. It is worth pointing out that 86% of the appointments were rated as Very Good or Good, a percentage that reached 92% when odontological treatment was concerned. In 1998, the respective figures were 86.2% and 93.1%.

Considering odontological treatment, the coverage by the National Health System (SUS) and by health insurance companies was low: 30.7% and 16.2%, respectively.

Over a million Brazilians do not seek medical treatment due to financial difficulties

Among those patients who sought medical treatment and did not obtain it, the main reasons presented for not being seen by a doctor were: excess of patients and consequent impossibility of treatment (48.9%) and insufficient number of doctors (25.5%).

Out of 5.01 million people who needed medical treatment but did not seek it, 23.8% (1.19 million) did not see a doctor due to lack of money; 18.1% because they considered the wait for the doctor too long; 12.7% for having trouble commuting to the office and 12.7% because of schedule incompatibility.

About 7% of Brazilians (12.3 million) had been hospitalized at least once in the year preceding the survey and, among those, 20.7% had been admitted to a hospital a second time within the same period. Among patients 65 years of age or over, the percentage of hospital admittance was twice as high: 14%.

One out of four Brazilians has health insurance

PNAD estimated that 43.2 million people (24.6% of the population ) had health insurance plans, most of them (34.2 million) private – individual or shared ones. The other nine million people had access to medical services under the responsibility of public institutions (municipal, state or military ones).In 1998, the percentage of patients covered by health insurance was 24.5%.

Concerning the urban population, 28% were covered by health insurance, whereas only 6.0% of the rural population was in the same conditions. The proportion of women having a health insurance plan (25.9%) was higher than the proportion of men (23.1%). By age groups, the percentage changed from 19.8% for age group 0-18 , to 29.8% for adults 65 years of age and over.

In the group of patients having health insurance, 26,2% rated their own health conditions as Good or Very Good and 14.1% considered their health Poor or Very Poor.

Most people seek medical treatment in municipal medical units

In 2003, PNAD estimated that 139.5 million Brazilians (79.3% of the population, whereas in 1998 the percentage was 71.2% ) had regular health services: rendered by municipal medical units (to 52.4% of the informants), by private offices (18%), by offices located in hospitals (16.9%), emergency wards (5.8%), clinics (4.4%) and pharmacies (1.4%).

Women outnumbered men in terms of requests for medical treatment (58.9% and 52.5%, respectively). The male population was bigger among those who went to hospital offices (17.2% male and 16.6 % female patients).

The search for treatment in municipal medical units and offices located in hospitals was more frequent among lower classes. Private medical offices and clinics were mentioned by patients with higher incomes.

Almost 28 million Brazilians have never been seen by a dentist 

The number of Brazilians who have never been to the dentist’s is still big, 27.9 million people (15.9% of the population). In 1998, they made up 18.7%. Among patients under five years old, the percentage of people who had never had their teeth checked by a dentist was 81.8%, falling to 22.1% for the age group 5-19 and to 6.3% for patients 65 years of age or over. There were discrepancies between the sexes : 17.5% of men and 14.3% of women declared not to have ever had odontological treatment. For the rural and urban populations, these percentages reached 13.6% and 28.0%, respectively.

Among families whose monthly income was up to one minimum wage, 31% had never had an appointment with a dentist. The figure fell to 3% when families receiving twenty or more minimum wages were concerned.

PNAD 2003 estimated that 62.8% of the population had been seen by a doctor at a certain moment in the twelve months preceding the interview (the percentage was 54.7% in 1998). By sex, the figures were 71.2% of women and 54.1% of men. For patients under five and over 65 years old the percentages were the highest 77.7% and 79.5%, respectively.

For the first time, PNAD investigates the occurrence of three essential preventive examinations

PNAD 2003 estimated that 34.4% of women over 40 had never undergone clinical breast examinations performed by a health professional. Nevertheless, 65.6% of women over 40 had already undergone the examination and over half of them (57.4%) had done it at most six months before the survey.

Approximately half of the women 50 years old or over had never undergone a mammography: 50.3% of them declared to have had the examination once before; 55.9% of them had done it the year preceding the survey. On the other hand, 79.1% of Brazilian women over 24 had had a Pap test at least once before.