Access to medicines, the Unified Health System, and intersectional injustices

OBJECTIVE: To estimate the prevalence of general and public access to prescription drugs in the Brazilian population aged 15 or older in 2019, and to identify inequities in access, according to intersections of gender, color/race, socioeconomic level, and territory. METHODS: We analyzed data from th...

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Detalles Bibliográficos
Autores: Bastos, João Luiz, Mujica, Elba Marina Miotto, Boing, Alexandra Crispim
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:Brasil
Institución:Universidade de São Paulo (USP)
Repositorio:Revista de Saúde Pública
Idioma:portugués
inglés
OAI Identifier:oai:revistas.usp.br:article/230112
Acceso en línea:https://www.revistas.usp.br/rsp/article/view/230112
Access Level:acceso abierto
Palabra clave:Accessibility to Health Services
Unified Health System
Intersectional Framework
Acessibilidade aos Serviços de Saúde
Sistema Único de Saúde
Enquadramento Interseccional
Descripción
Sumario:OBJECTIVE: To estimate the prevalence of general and public access to prescription drugs in the Brazilian population aged 15 or older in 2019, and to identify inequities in access, according to intersections of gender, color/race, socioeconomic level, and territory. METHODS: We analyzed data from the 2019 National Health Survey with respondents aged 15 years or older who had been prescribed a medication in a healthcare service in the two weeks prior to the interview (n = 19,819). The outcome variable was access to medicines, subdivided into general access (public, private and mixed), public access (via the Unified Health System - SUS) for those treated by the SUS, and public access (via the SUS) for those not treated by the SUS. The study’s independent variables were used to represent axes of marginalization: gender, color/race, socioeconomic level, and territory. The prevalence of general and public access in the different groups analyzed was calculated and the association of the outcomes with the aforementioned axes was estimated with odds ratios (OR) using logistic regression models. RESULTS: There was a high prevalence of general access (84.9%), when all sources of access were considered, favoring more privileged segments of the population, such as men, white, and those of high socioeconomic status. When only the medicines prescribed in the SUS were considered, there was a low prevalence (30.4% access) that otherwise benefited marginalized population segments, such as women, black, and people from low socioeconomic backgrounds. CONCLUSIONS: Access to medicines through the SUS proves to be an instrument for combating intersectional inequities, lending credence to the idea that the SUS is an efficient public policy for promoting social justice.