ACESSO DE PESSOAS IDOSAS AOS SERVIÇOS DE SAÚDE NA ATENÇÃO PRIMÁRIA

Abstract

Due to population aging, strategies are being developed to provide comprehensive and effective healthcare. Among these strategies is the access to health services. Thus, this study aimed to analyze the access of elderly individuals to health services in Primary Health Care in a municipality in the interior of Paraná. This is a descriptive cross-sectional quantitative study with data collected through the application of a structured interview, including questions related to sociodemographic and clinical profiles and access to health services. The probabilistic sample consisted of randomly selected elderly individuals registered in five Basic Health Units defined by lottery. Inclusion criteria for participants were: being 60 years of age or older, of both sexes, residents, and registered in the selected areas of the investigation municipality; exclusion criteria were participants not located at the address, not found at home after three return attempts, and those who, due to cognitive limitations, presented inconsistencies in their responses. The data collection period was from November 2022 to May 2023. The research project was reviewed and approved by the institutional ethics committee under opinion number 5,593,896. The data were analyzed using descriptive and inferential statistics, employing the Statistical Package for the Social Sciences, and the significance level for analyses was set at 0.05. Results from a representative sample of 396 elderly individuals showed that access to health services for the majority (n:252, 63,64%) of participants occurred through the Basic Health Unit, mentioned as easily accessible due to its proximity to the residence of the interviewed users (n:184, 46%), and the majority (n:273, 68,9%) received same-day care. However, some barriers were identified, with 41% (n:56) reporting delays in appointment scheduling, and 46.34% (n:152) facing difficulties in obtaining free continuous-use medications. Seeking care in the last month for 46.2% (n:84) of participants was a result of treatments or disease monitoring. Significant characteristics (p<0.001) related to access included the proximity of reference services to the participant's residence within one kilometer; receiving help, specifically assistance and/or arranging transportation; travel time of 1-15 minutes, with walking being the most commonly used method and no cost to travel to health services. Significant differences (p<0.001) were identified between access to health services for elderly individuals residing in urban and rural areas, with the rural region facing greater access difficulties related to distance and transportation, as well as having less knowledge about the functioning of the health services they use compared to the urban region. This study provided elderly individuals the opportunity to share their perceptions as users of services, and the results can support the development of actions and adjustments in public health policies, leading to improvements in access to health services for the elderly population.