Private Health Care Coverage in the Brazilian population, according to the 2013 Brazilian National Health Survey

Malta, Deborah Carvalho; Stopa, Sheila Rizzato; Pereira, Cimar Azeredo; Szwarcwald, Célia Landmann; Oliveira, Martha; Reis, Arthur Chioro dos

doi:10.1590/1413-81232017221.16782015

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Free Themes • Ciênc. saúde colet. 22 (1) • Jan 2017 • https://doi.org/10.1590/1413-81232017221.16782015 copy

Private Health Care Coverage in the Brazilian population, according to the 2013 Brazilian National Health Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aims to present the percentages of the Brazilian population holding health insurance plans, itemized by social-demographic characteristics, based on the data of the National Health Survey carried out in 2013, and to compare this information with the administrative data of the National Supplementary Health Agency for the same year. Data from the National Health Survey, and from the Beneficiaries Information System of the National Health Agency for the year 2013, were used. The percentage of people having a health plan was described according to stratification for: all of Brazil, urban/rural, Brazilian official Regions, Brazilian States and state capitals, gender, age group, level of schooling, position in the workforce, ethnic classification, and self-assessed state of health. Results include the following: The percentage of people saying they had some health plan in Brazil was 27.9% (CI 95%: 27.1-28.8). A significant difference was found relating to level of schooling – the percentage being highest for those who stated they had complete secondary education (68.8% CI 95%: 67.2-70.4) and for those who said they were currently in work (32.5% CI 95%: 31.5-33.5). The increase in health plan coverage in the Brazilian population reflects the improvement of the suply of employment and the growth in the country's economy.

Key words
Pre-paid health plans; Prevalence of private health plans; Epidemiological surveys; Health services; Brazil

Sub-category	% having some health plan	CI lower limit	CI upper limit	Estimated total number (’000)
Gender
Male	27,0	26,1	27,9	26,045
Female	28.8	27.9	29.7	29,940
Age group (years)
0-17	23.1	22.1	24.0	12,516
18-29	26.0	25.0	27.1	10,114
30-39	31.3	30.1	32.6	9,703
40-59	31.0	29.8	32.1	15,514
Over 60	30.8	29.3	32.3	8,138
Level of schooling
No education, or primary incomplete	16.4	15.7	17.1	15,065
Primary complete, secondary incomplete	22.8	21.7	23.9	6,704
Secondary complete, higher incomplete	37.4	36.3	38.5	18,020
Higher education complete	68.8	67.2	70.4	12,733
Racial group
White	37.9	36.6	39.2	34,856
Black	21.6	19.9	23.3	3,743
Mixed race	18.7	18.0	19.4	16,592
Workforce status
In work	32.5	31.5	33.5	30,199
Out of work	16.3	14.4	18.1	926
Not in workforce	24.7	23.6	25.7	15,251
State of health
Very good, or good	31.3	30.3	32.3	46,536
Average	19.1	18.2	20.0	8,245
Bad, or very bad	13.8	12.4	15.2	1,204
Home location
Urban	31.7	30.7	32.7	54,136
Rural	6.2	5.2	7.2	1,849
Regions
North	13.3	12.2	14.4	2,225
Northeast	15.5	14.6	16.5	8,639
Southeast	36.9	35.2	38.6	31,163
South	32.8	30.4	35.2	9,437
Center-West	30.4	28.7	32.0	4,521
All of Brazil	27.9	27.1	28.8	55,985

Indicators	Total			Gender
	Total			Male			Female
	%	CI 95%		%	CI 95%		%	CI 95%
Population aged 18 and over:
Have held a health plan (medical or dental) for more than one year without interruption	23.5	22.7	24.3	22.5	21.7	23.4	24.3	23.5	25.1
Have more than one health plan	2.7	2.4	2.9	2.6	2.3	2.8	2.7	2.5	3.0
Have an exclusively dental health plan	5.2	4.8	5.5	5.2	4.8	5.5	5.1	4.8	5.5
Have a health plan under a government workers’ healthcare institution (municipal, state or military)	6.1	5.7	6.4	5.6	5.2	6.0	6.4	6.1	6.8
Population with a health plan:
% with a health plan who assess their principal health plan (medical or dental) as good or very good	72.1	71.0	73.2	72.4	71.1	73.7	71.8	70.7	73.0
% who have some health plan (medical or dental) and are its nominal holder	47.7	46.9	48.5	54.5	53.5	55.5	41.8	40.6	43.0
Health plan is paid by the nominal holder's employer	32.4	31.3	33.4	32.3	31.0	33.6	32.4	31.3	33.6
Health plan is paid by the nominal holder through present or previous employment	31.6	30.4	32.7	35.6	34.2	37.0	28.0	26.8	29.3
Health plan is paid directly by the nominal holder	25.2	24.2	26.3	22.5	21.3	23.7	27.7	26.5	28.8

Indicators	Total			Age groups
	Total			0–17			18–29
	%	CI 95%		%	CI 95%		%	CI 95%
Population aged 18 and over:
Have held a health plan (medical or dental) for more than one year without interruption	23.5	22.7	24.3	17.4	16.5	18.2	20.1	19.2	21.1
Have more than one health plan	2.7	2.4	2.9	2.4	2.1	2.7	2.4	2.1	2.7
Have an exclusively dental health plan	5.2	4.8	5.5	4.7	4.3	5.1	5.5	5.0	6.0
Have a health plan under a government workers’ healthcare institution (municipal, state or military)	6.1	5.7	6.4	4.3	4.0	4.7	4.6	4.2	5.1
Population with a health plan:
Assess their principal health plan (medical or dental) as good or very good	72.1	71.0	73.2	72.8	71.1	74.6	73.3	71.6	75.0
Have some health plan (medical or dental) and are its nominal holder	47.7	46.9	48.5	3.5	2.9	4.2	48.2	46.3	50.2
Health plan is paid by the nominal holder's employer	32.4	31.3	33.4	48.6	46.8	50.5	35.4	33.4	37.3
Health plan is paid by the nominal holder through present or previous employment	31.6	30.4	32.7	20.1	18.5	21.7	34.2	32.2	36.2
Health plan is paid directly by the nominal holder	25.2	24.2	26.3	18.0	16.5	19.5	18.7	17.2	20.2

Indicators	Age groups
	30–39			40–59			60 and over
	%	CI 95%		%	CI 95%		%	CI 95%
Population aged 18 and over:
Have held a health plan (medical or dental) for more than one year without interruption	26.0	24.8	27.1	28.0	26.9	29.1	29.3	27.8	30.8
Have more than one health plan	3.5	3.1	3.9	3.1	2.8	3.4	1.7	1.4	2.1
Have an exclusively dental health plan	7.3	6.6	7.9	5.5	5.1	5.9	2.4	2.0	2.8
Have a health plan under a government workers’ healthcare institution (municipal, state or military)	5.5	5.0	6.0	8.0	7.4	8.6	8.7	7.9	9.4
Population with a health plan:
Assess their principal health plan (medical or dental) as good or very good	73.2	71.4	74.9	71.5	70.0	73.1	69.2	67.2	71.3
Have some health plan (medical or dental) and are its nominal holder	64.5	63.0	66.0	64.6	63.5	65.7	62.9	61.2	64.5
Health plan is paid by the nominal holder's employer	30.3	28.5	32.1	27.0	25.6	28.3	16.5	15.0	18.0
Health plan is paid by the nominal holder through present or previous employment	39.3	37.3	41.4	38.5	36.7	40.2	23.5	21.6	25.4
Health plan is paid directly by the nominal holder	23.0	21.2	24.7	27.2	25.7	28.7	43.5	41.1	45.8

Indicators	Total			Level of schooling
	Total			No education, or primary incomplete			Primary complete and secondary incomplete			Secondary complete and higher education incomplete			Higher education complete
	%	CI 95%		%	CI 95%		%	CI 95%		%	CI 95%		%	CI 95%
Population aged 18 and over:
Have held a health plan (medical or dental) for more than one year without interruption	23.5	22.7	24.3	14.1	13.5	14.8	18.8	17.8	19.8	31.5	30.4	32.5	63.4	61.7	65.1
Have more than one health plan	2.7	2.4	2.9	1.2	1.1	1.4	1.9	1.6	2.3	3.6	3.2	4.0	8.5	7.6	9.4
Have an exclusively dental health plan	5.2	4.8	5.5	2.6	2.4	2.9	4.6	4.1	5.1	7.6	7.0	8.1	12.6	11.6	13.6
Have a health plan under a government workers’ healthcare institution (municipal, state or military)	6.1	5.7	6.4	3.3	3.0	3.6	4.4	3.9	4.9	8.3	7.8	8.9	17.8	16.7	19.0
Population with a health plan:
People who assess their principal health plan (medical or dental) as good or very good	72.1	71.0	73.2	68.2	66.4	70.0	71.1	69.0	73.3	73.1	71.7	74.5	74.8	73.2	76.4
% who have some health plan (medical or dental) and are its nominal holder	47.7	46.9	48.5	31.4	30.1	32.8	42.3	40.3	44.3	58.6	57.4	59.9	67.4	66.0	68.8
Health plan is paid by the nominal holder's employer	32.4	31.3	33.4	34.4	32.8	36.0	35.8	33.6	38.1	30.7	29.3	32.0	25.1	23.6	26.7
Health plan is paid by the nominal holder through present or previous employment	31.6	30.4	32.7	22.9	21.3	24.4	28.8	26.7	31.0	37.7	36.1	39.3	38.0	36.2	39.8
Health plan is paid directly by the nominal holder	25.2	24.2	26.3	27.1	25.5	28.7	24.4	22.4	26.4	22.4	21.1	23.7	29.7	28.0	31.5

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E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

DC Malta, SR Stopa, CA Pereira, CL Szwarcwald, M Oliveira and AC Reis participated in the study design, data analysis and interpretation, writing, review and final approval of the article, and are responsible for all aspects including warranty accuracy and integrity.