Use of health services by adults in Manaus, 2019: Protocol of a population-based survey

Abstract

Introduction: Health services utilization is an indirect measure of the rights and equity of a health system. A 2015 survey conducted in the Manaus metropolitan region showed that in the previous year, over 70% of adults visited the doctor and 1 in 3 had visited a dentist. Socioeconomic factors and inequality played a central role in the usage of healthcare services and health situation in this population. Since then, political and economic crisis are evolving in Brazil. This project aims to estimate the prevalence of use of health services and the health status of the adults residing in Manaus in 2019.

Methods and analysis: This is a population-based survey of adults (≥18 years old) residing in Manaus. This survey will be conducted in the first half of 2019 with 2300 participants who will be interviewed at home, selected from a probabilistic sampling in 3 stages (census tracts, household, and dweller), and stratified by sex and age quotas based on official estimates. The participants will be interviewed using previously validated tools and questions employed in Brazilian official surveys, which will cover use of health services and supplies, health status, and lifestyle. Primary outcome will be any healthcare usage in the last 15 days. Associations between health services usage and socioeconomic data and health outcomes will be assessed using a Poisson regression with a complex sampling design correction. Results will be reported according to the strengthening the reporting of observational studies in epidemiology statement.

Ethics and dissemination: This project was approved by the Ethics Committee of the Federal University of Amazonas, Manaus, Amazonas, Brazil. All participants will sign an informed consent before the interview. The results will be disseminated in peer-reviewed manuscripts, reports, conference presentations, and through the media.

Figure 1

Hypothesized relationship of the outcomes to be assessed on the Manaus population-based survey, 2019.