Caracterização dos usuários e do acesso às órteses, próteses e auxiliares de locomoção e movimento com base na PNS 2019 e no SIA/SUS

Abstract

Introduction: Access to orthoses, prostheses, and mobility aids, as well as rehabilitation services, presents a significant challenge for individuals with physical disabilities in Brazil. The unequal availability of resources, inadequate infrastructure, and difficulties accessing the Unified Health System (SUS) directly impact the quality of life of these individuals. Objective: To investigate the use of orthoses, prostheses, and mobility aids by people with physical disabilities in Brazil, based on data from the 2019 National Health Survey (PNS) and the 2019 Ambulatory Information System (SIA/SUS), aiming to understand regional variations, access patterns, and implications for public health policies. Method: This is an observational, descriptive study with a quantitative approach, focusing on the sociodemographic characterization of users of mobility devices. Universe and Sample: The sample included 121,520 individuals who responded to the PNS questionnaire, with 9,125 using mobility devices. The study focused on sociodemographic variables such as gender, age, race/ethnicity, education, marital status, income, as well as access to SUS and rehabilitation services. Variables: The research addressed sociodemographic variables and access to rehabilitation. Socioeconomic variables included gender, age, ethnicity, income, marital status, education, and distribution by federative units. The study analyzed the use of mobility devices, access to SUS, and rehabilitation, including classifications of the groups Physical, OPM Physical, and OPM Physical FAEC. Analysis: Data analysis was conducted using SPSS, Excel 2019, and software RStudio versão 2022.2.3.492 (R Foundation for Statistical Computing, Boston, EUA), focusing on descriptive statistics of absolute and relative frequencies of the variables. The analysis aimed to identify socioeconomic patterns, the prevalence of mobility device use, and access to rehabilitation services, with an emphasis on SUS’s role. Results: The study revealed that most respondents were brown and single, while users of mobility devices tended to be white and married. The highest prevalence of device use was observed in the Northeast, with the highest number of dispensing records in the Southeast. The use of mobility aids was more frequent for lower limbs, and most participants received rehabilitation care through healthcare services. Non-profit organizations were predominant in providing rehabilitation services, while fixed orthopedic workshops recorded the highest dispensing of mobility aids. Conclusion: The analysis of the distribution of orthoses, prostheses, and mobility aids in Brazil highlights significant inequalities in access and availability. The population most in need of these devices is concentrated in vulnerable areas, where socioeconomic, racial, and regional factors limit access to healthcare services. Poor infrastructure and a lack of qualified professionals exacerbate difficulties, resulting in long waiting times and barriers to care. More developed regions with better infrastructure offer more accessible healthcare services, reflecting the historical centralization of resources in these areas.