Equidade na utilização dos serviços de saúde no Brasil: um estudo comparativo entre as regiões brasileiras no período 1998-2008

Brazil presents severe socioeconomic inequalities among regions and individuals. Several studies analyze the determinants of these inequalities and its effects on social welfare indicators, such as health. This paper measures the socioeconomic inequalities in healthcare utilization in Brazil and in Brazilian regions over the period 1998-2008, using the Brazilian household survey, Pesquisa Nacional por Amostra de Domicílios (PNAD). Health concentration curves and indexes – CC and CI – were estimated. This methodology takes into account differences throughout the income distribution. The results show a consistent improvement during the period. These improvements were largest among individuals without health insurance, suggesting an improvement at Brazilian Health System (SUS) services. The estimation of CC and IC suggests a small magnitude of inequality in outpatient and hospital services. The dental service is the only one, among the healthcare utilization variables, with relevant magnitude of inequality favoring of the richest groups. The analysis of healthcare access suggests the presence of constrained demand more concentrated among the poorest groups, especially for the population without health insurance. This study moves forward in the health equity literature since it analyzes equity at SUS in the last ten years considering differences among socioeconomic groups and Brazilian regions.