Utilization of the family health program in a Brazilian metropolitan region: A methodological approach

Given its importance in the Brazilian health policies scenario, mainly in primary health care, the Family Health Program (FHP) has been the object of several studies. However, few investigations perform a breakdown of the utilization profile of these services considering the entire enrolled population. The option that prevails is to conduct inquiries into users of Family Health Units (FHU). So, this research aims to present the methodological approach used to define the profile of health services utilization by the population enrolled in the FHP. METHODS: There are three patterns of utilization of the services accessed by the population: residual, partial and full. These patterns were identified based on the range of actions of the FHP that are accessed by the population. An inquiry was conducted in 2006 with two-stage sampling in an area characterized by high levels of social exclusion in the city of São Paulo. In the first stage, 960 people participating in family health teams were drawn and classified by the community-based health agents as “full use” or not of the health services. In the second stage, 173 drawn subjects were then classified according to the patterns of services utilization. RESULTS: Subjects were classified as full users (16%), partial users (57%) and residual users (26%), and had different social and demographic characteristics. There is a selective and focused utilization of the services offered by the Family Health Program. Being male, having a level of schooling above the fifth grade of elementary school, having a paid job and accessing medical care systems imply lower adhesion to the services. Even in area of high social exclusion and low offer of health services, 25% of the enrolled population do not use the services offered at the FHU, receiving only home visits.