Health services utilization in areas covered by the family health program (Qualis) in Sao Paulo City, Brazil

Objective The Family Health Program (FHP) is a strategy for reorganizing the healthcare attendance system within the Brazilian National Health System. The objective of the study was to assess whether there had been changes in the utilization profile of the healthcare services following implementation of the program, and to identify factors associated with any changes observed. Methods Data on service utilization and demand for attendance were analyzed by means of two cluster-based population samples, representing areas covered (n = 1865) and not covered (n = 2036) by the FHP in two districts of the municipality of Sao Paulo. The data formed part of a population survey carried out in 2001. Statistical methods for cluster analysis were used. Results In the area covered by the FHP, no statistically different prevalence ratios (PR) according to schooling and income levels were observed for service utilization. In the area not covered by the FHP service utilization was positively associated with greater schooling and income. Among individuals with illnesses, the demand for attendance in the area covered by the FHP was higher (higher PR) among those with severe physical limitations. In the area not covered, the PR was higher among those with greater schooling and lower among those who were inactive (unemployed or retired). Conclusions In the areas studied, for the population covered by the FHP income and schooling levels did not constitute factors that significantly differentiated the utilization profile of the healthcare services and the demand for attendance. This indicates that the program may be contributing towards greater equity under these conditions.