(208) Relationship between access to medicines in the unified health system and users' perception of health in the context of the national survey on access, use and promotion of the rational use of medicines

Publication Number: 869

Background: Medication has become an essential key to promoting quality of life, therefore access to medication is considered an indicator of the quality and resolution of the health.

Objectives: To measure, through a unique indicator, access to medication in a sample of the Brazilian population and its association with health measures of patients.

Methods: It is part of the National Survey on Access, Use and Promotion of the Rational Use of Medicines – Services 2015, a cross-sectional, exploratory, evaluative study, consisting of a survey of information on a representative sample of municipalities, stratified by regions of Brazil. The evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, geographic accessibility, adequacy, acceptability and purchasing, for this analysis, the "unique indicator of access to medicines" was considered the variable response and was calculated using the weighted means of each dimension. Categorical variables were presented as absolute and relative frequencies and chi-square tests were performed for categorical variables.

Results: . The sample is composed by 4.391 people, mostly women (77.5%) and aged less than 60 years old (72.9%). The user profile shows a brown majority (51.7%), with low education (50.5%) and low income. The average found for the single access indicator was 0.6. However, 31.4% of users show that they have no access to their medication. Still 25.9% of the population studied demonstrates having full access to prescribed medications. It is possible to notice that there is no relationship between the medical perception and the user's access to the medication, however, for the variables related to financing and shortages in the view of the health managers in the municipality, apparently there is a relationship between them, since p-value < 0.001 for all of them. With regard to user health, it is also possible to see the relationship between them, and it is possible to see that those with full access have a better perception of their health and use less emergency and hospitalization services.

Conclusions: Although Brazil has several public policies that cover access to medicines, worrying data were found for patients who report not having access to their medicines, which demonstrates the need for evaluation and restructuring of existing policies. The evaluated variables show that access to medication can directly interfere with the patient's health and the probability of having a health emergency or requiring hospitalization, two services that are very costly for the health system. The management of resources by municipal health secretaries and those responsible for pharmaceutical care in the city also have a direct influence on access to medication.