Discriminação nos Serviços de Saúde em Universitários de uma cidade do Sul do Brasil

Abstract

This study is nested to a master consortium- 2017/2018 of the Graduate Program in Epidemiology of the Federal University of Pelotas. 1865 students answered a self-administered and anonymous questionnaire, over 18 years of age, enrolled at the Federal University of Pelotas in the first semester of 2017 and who were attending the second semester of one the 80 courses participating in this research. Data were collect with the goal of evaluating the discrimination in health services suffered in the students’ lives. The reasons for perceived discrimination in the health services questioned were: Lack of money, Social class, Race/skin color, Type of occupation; Type of disease; Sexual preference; Religion/belief; Sex, Age and others. The service nature where the discrimination occurred were differentiate between SUS, private or health insurance. The professional linked to the outcome was categorized as a receptionist or administrator; security of service; nurse technician, nurse, doctor, dentist and others. The association with the outcome was evaluate according to the sociodemographic variable that identified the economic class according to the Brazilian Association of Companies and Research (ABEP). The demographic variables for the association were sex, age, skin color, region of origin of the student. In addition, the behavioral variable characterized the students in smokers, ex-smokers and nonsmokers. The description of the prevalence of each reason for perceived discrimination was calculate with a 95% confidence interval. Total discrimination was calculate by summing up all grounds for discrimination. In addition, the associations were calculate by crude and adjusted with Poisson regression. The main results were a total prevalence of discrimination in the health services throughout the life of 22.8%, and the most related reasons were social class and lack of money, 11% (95% CI 9.0, 12, 0) and 10.1% (95% CI 9.0, 12.0). The SUS was service nature where most discrimination occurred (58%). The doctors (51.1%) and the receptionists (42.4%) were the professionals most associated with discrimination. Pelotas (59.1%) was refer to as the site of greatest discrimination occurrence. In summary, the prevalence observed was one of the highest in the literature, which indicates the magnitude of the problem of the professional-patient relationship. This volume includes: the research project, the fieldwork report, the changes made in the original project, the press release and the appendices and annexes, which include the protocol of acceptance of the Research Ethics Committee, the term of the free and informed consent of the study, the questionnaire used in the data collection, the instruction manual and the publication standards of the Reports in Public Health, for which the article of this dissertation will be submitted.