Pricila Mullachery|Diana Silver|James Macinko
Changes in health care inequity in Brazil between 2008 and 2013
New York University|New York University|Oklahoma State University Center for Health Sciences|University of California, Los Angeles
brazil made progress towards equitable distribution health care gains may threatened economic instability resulting 2008 global financial crisis study measured predictors health care utilization changes horizontal inequity 2008 2013 data two nationally representative surveys measured variety sociodemographic health behaviors health care indicators used poisson regression models estimate adjusted prevalence ratios horizontal equity index hei standardized health needs measure inequity utilization doctor dentist visits hospitalizations reporting usual source care usc 18 older estimate hei ranked population poorest richest using wealth index also decomposed hei different components assessed changes 2008 2013 population proportion doctor dentist visits past year usc increased 2008 2013 hospitalizations declined 2013 prorich inequity doctor visits increased significantly distribution hospitalizations shifted prorich 2008 neutral 2013 dentist visits highly prorich usc slightly prorich distribution dentist visits usc change time health need strong predictor health care utilization regardless type coverage public private education wealth private health plans associated prorich orientation doctor dentist visits private health plans contributed prorich orientation outcomes family health strategy contributed propoor orientation outcomes results study support claim brazils population continued see absolute gains access care despite recent economic crises however gains equity slowed may even decline investments maintained country enters deeper financial political crises