Multimorbidity and the use of health services in the Brazilian population: National Health Survey 2019.

Abstract

Objective: To describe the prevalence of health service use due to multimorbidity according to sociodemographic and health characteristics of the Brazilian population; to analyze the relationship between multimorbidity and the use of health services.

Methods: This was a cross-sectional study using data from the 2019 National Health Survey. The outcomes were seeking health services in the last 15 days, medical consultation and hospitalization in the previous 12 months. Multimorbidity was defined as ≥ 2 chronic diseases. Associations were assessed using Poisson regression.

Results: Of the 81,768 individuals, prevalence of seeking health services among individuals with multimorbidity was 38.0% higher (95%CI 1.31;1.45), medical appointments, 11.0% higher (95%CI 1.10;1.12), and 56.0% higher for hospitalizations (95%CI 1.44;1.70), compared to those without multimorbidity. This relationship was higher for seeking health services and medical appointments among male.

Conclusion: The use of health services was higher among those with multimorbidity, but different between the types of health services used and sexes.

Main results: Having multimorbidity increased the use of health services, even after progressive adjustment by sociodemographic characteristics and health needs. This relationship was greater among males for medical consultations.

Implications for services: Greater use of health services by individuals with multiple non-communicable diseases (NCDs) points to the need for changes in care models, with focus on continuity of care.

Perspectives: Health services should focus on continuous, coordinated and comprehensive approaches to the care of people with multimorbidity, thus seeking to increase the efficiency and quality of care provided to this population.