Analysis of hospital admissions associated factors in Brazil

O objetivo foi identificar fatores associados ??s admiss??es hospitalares no Brasil, analisando se essa utiliza????o ?? eq??itativa e identificando caracter??sticas associadas aos grandes usu??rios. A PNAD/1998 foi analisada, utilizando regress??o log??stica e regress??o log??stica multinomial, com pesos normalizados e t??cnicas estat??sticas para corre????o do efeito de desenho. O modelo te??rico utilizado foi o Comportamental de Andersen. No modelo ajustado por necessidade de sa??de e fatores capacitantes, pessoas com menor renda apresentaram maior chance de se internar; o contr??rio ocorreu no modelo ajustado somente por necessidade de sa??de. Todas as vari??veis de necessidade mostraram-se menos relacionadas ao uso nas pessoas com duas interna????es, em compara????o com aquelas com mais do que duas interna????es. N??o houve associa????o entre vari??veis sociais e ocorr??ncia de duas interna????es, mas essa associa????o ocorreu para tr??s ou mais interna????es. A redu????o das desigualdades sociais nos aspectos que "capacitam" ao uso de admiss??es hospitalares reduziria as desigualdades neste uso. Um sistema de sa??de que ofere??a um "servi??o de uso regular", al??m de baixo ou nenhum pagamento no ato do consumo, seriam medidas de impacto positivo na eq??idade do consumo de servi??os hospitalares no Brasil.The objective was to identify hospital admission associated factors in Brazil, analyzing if that utilization is equitable and identifying which characteristics are associated with heavy users. We analyzed data from the 1998 National Household Survey, using logistic regression and multinomial logistic regression, with normalized weights and statistical techniques to correct for design effect.We used Andersen???s Behavioral Model as the theoretical model for this analysis. In model adjusted for health needs and enabling factors, people with smaller income had more chance of being admitted to hospital; and in model adjusted only for health needs people with larger income had more chance. All need variables were less related to use for people with two hospital admissions, in comparison with those with more than two admissions; and there was no association between social variables and occurrence of two admissions, but this association occurred for three or more admissions. The reduction of social inequalities in the aspects that ???enable??? people to use hospital admissions would reduce inequalities in this use. A health system that offers a ???regular health service???, besides low or any payment in the moment of use, would have a positive impact in the equity of hospital admission utilization in Brazil