There is strong evidence from developing countries to support the hypothesis that physical accessibility of health services, particularly absolute distance from clinics, is a major determinant of health service utilization and health status. In South Africa, such evidence is very limited and as a result the relationship between absolute distance and health service utilization and health status is not fully understood. As an attempt to understand this relationship, a household survey of mothers with children aged 12-23 months was conducted in a rural district of KwaZulu-Natal province, South Africa. Maternal and child health (MCH) service utilisation and MCH status patterns were then compared at different absolute distances from PHC clinics. The find ings reveal that the study population is characterised by impoverished living conditions (86%), high functional illiteracy (67%), high fertility and unemployment rates . In comparison with other studies conducted previously in the same population, MCH service utilization rates are high. Based on mean distances of homesteads from PHC clinics in the entire study area before the Clinic Upgrading and Building Programme it has been concluded that the physical accessibility of fixed PHC clinics, when compared with the WHO recommendations, was suboptimal. When this assessment is based on clinic usage patterns, it is found that clinic usage decreased from 86.4% at 0-5 km to 79% at 6-10 km with a dramatic decrease to 37.8% at distances beyond 10 km. This decrease in usage at distances above 5 km translates into a considerable reduction in effective coverage of the target population by PHC clin ic services if it is considered that above 50% of the population live greater than 5 km from these clinics. An assessment of the effect of distance of homesteads from PHC clinics on specific MCH service utilization and MCH status has found very few or no significant differences between mothers and children living at 0-5 km, 6-10 km or > 10 km from these clinics. This observation is consistent even after adjustment for the effects of potential confounding. The fact that distance from clin ics has little or no effect on the indicators of MCH service utilization and MCH status is counter-intuitive. A few explanations can be provided. These include the fact that only 50% of the population, even in one of the most rural parts of South Africa access clinics on foot. Since the traditional assumption has been that this distance effect is a function of straight-line walking distances between homesteads and clinics, Euclidian distances alone may be a poor explanatory variable for health service utilization. Furthermore, if the hypothesis is valid that health status is a function of service utilization, it may also be a poor explanatory variable for health status of community members who are reliant on these services. Secondly, based on data from other sources, there is evidence that there have been steady declines in both mortality and fertility rates in the study population over the past 10-20 years suggesting that client communities are already benefiting quite substantially from health services in general and from MCH services in particular in spite of residual distance barriers. In other words, this distance effect on service utilization and health status may be more evident in populations with much higher background infant, child and maternal mortality rates. Thirdly, it is also possible that distance effect still exists, but that methodological limitations prevented this study from showing this effect. For instance, the fact that people use mobile clinics for some MCH services may have confounded the effect of distance from fixed clinics. It is also possible that people use different facilities for different services even though they are further away, and the assumption that all facilities have equal attraction for clients and that the only determinant of use is distance may be flawed. For example, it is evident from this and from other studies in South Africa that whereas most clients use fixed clinics for vaccinations, deliveries are now increasingly conducted at hospitals. Other methodological issues include the fact that certain health outcomes such as stunting are not an exclusive reflection of health service inputs, but are a function of social and economic determinants. Based on these findings, a number of recommendations are made. / Thesis (Ph.D.)-University of Natal, Durban, 2004.

But : La radiothérapie (RT) est disponible seulement dans les grandes villes au Québec. Les patients atteints de cancer vivant en zone rurale doivent voyager pour obtenir ces soins. Toute proportion gardée, moins de ces patients accèdent à la RT. L’accessibilité serait améliorée en instaurant de petits centres de RT qui dépendraient de la télémédecine (téléRT). Cette étude tente (1) de décrire un modèle (population visée et technologie) réaliste de téléRT; (2) d’en estimer les coûts, comparativement à la situation actuelle où les patients voyagent (itineRT). Méthode : (1) À l’aide de données probantes, le modèle de téléRT a été développé selon des critères de : faisabilité, sécurité, absence de transfert des patients et minimisation du personnel. (2) Les coûts ont été estimés du point de vue du payeur unique en utilisant une méthode publiée qui tient compte des coûts en capitaux, de la main d’oeuvre et des frais généraux. Résultats : (1) Le modèle de téléRT proposé se limiterait aux traitements palliatifs à 250 patients par année. (2) Les coûts sont de 5918$/patient (95% I.C. 4985 à 7095$) pour téléRT comparativement à 4541$/patient (95%I.C. 4351 à 4739$) pour itineRT. Les coûts annuels de téléRT sont de 1,48 M$ (d.s. 0,6 M$), avec une augmentation des coûts nets de seulement 0,54 M$ (d.s. 0,26 M$) comparativement à itineRT. Si on modifiait certaines conditions, le service de téléRT pourrait s’étendre au traitement curatif du cancer de prostate et du sein, à coûts similaires à itineRT. Conclusion : Ce modèle de téléRT pourrait améliorer l’accessibilité et l’équité aux soins, à des coûts modestes. / Purpose: Radiotherapy (RT) is centralized in urban areas in Quebec. Patients with cancer living in remote areas must travel to receive RT, and the proportion of RT patients is inferior to that of urban patients. Telemedicine could allow a minimally staffed RT unit to operate at reasonable costs in a rural setting. This study aims (1) to outline a feasible structure and target population for a tele-radiotherapy unit (teleRT); and (2) to estimate the costs of teleRT, compared to the current situation based on travel to urban centres (travelRT). Methods and Materials: (1) We developed an evidence-based teleRT model meeting the criteria of: feasibility & safety, elimination of patient travel, and minimisation of staff migration. (2) Costs were estimated from the public payor perspective using a previously published activity-based costing model for RT. The model included annualized capital costs, labour, and overhead. Results: (1) In our model, teleRT was restricted to 250 palliative care patients per year. (2) The public payor cost of teleRT was 5918$/patient (95% C.I. 4985 to 7095$) as compared to 4541$/patient (95%C.I. 4351 to 4739$) for travelRT. Yearly costs of the teleRT unit was 1,48 M$ (s.d. 0,6 M$), with a net cost increase to the payor of 0,54 M$ (s.d. 0,26 M$) compared to travelRT. Under less stringent conditions, breast and prostate cancer patients could also benefit from teleRT at similar costs to travelRT. Conclusion: Establishing a teleRT unit to treat a small rural population of palliative care patients results in a modest net increase in cost to the public payor and could lead to increased accessibility and equity.

Thesis (MMed) -- Stellenbosch University, 2010. / Bibliography / Objectives: To describe the establishment of a colposcopy service in a district hospital in a rural sub-district and to assess its impact on the uptake of colposcopy. Design: A retrospective double group cohort study using a laboratory database of cervical cytology results, clinical records and colposcopy clinic registers. Setting: The Overstrand sub-district in the Western Cape: 80 000 people served by 7 clinics and a district hospital in Hermanus, 120 km from its referral hospitals in Cape Town and Worcester. A colposcopy service was established at Hermanus Hospital in 2008. Subjects: All women in the Overstrand sub-district who required colposcopy on the basis of cervical smears done in 2007 and 2009. Outcome measures: The number of women booked for colposcopy at distant referral hospitals in 2007 and at the district hospital is 2009, the proportion of those women who attended colposcopy, the time from cervical smear to colposcopy, comparison between the two years. Results: The uptake of colposcopy booked for distant referral hospitals was 67% in 2007. The uptake improved by 18% to 79% for the local district hospital colposcopy service in 2009 (p=0.06). When analysed excluding patients from an area with no transport to the district hospital, the improvement was more marked at 22% (p=0.02). The delay from cervical smear to colposcopy improved significantly from 170 to 141 days (p=0.02). Conclusion: The establishment of a colposcopy service in a rural sub-district increased the uptake of colposcopy and decreased the delay from cervical smear to colposcopy. This district hospital colposcopy service removed 202 booked patients in one year from the colposcopy load of its referral hospitals.

Thesis (MFamMed)--Stellenbosch University, 2012. / INTRODUCTION: Access to health care, like childhood survival, often depends on where one lives. The infant mortality rate in rural South Africa (SA) is 52.6 per 1000 births, compared to 32.6 per 1000 births in urban areas. Furthermore, three of the four districts in SA with the highest HIV prevalence are rural. These being two commonly used health indicators, it is clear that rural populations have significantly poorer health outcomes than their urban counterparts. About half the world’s population live outside major urban centres, where health services and specialist medical services are concentrated. Rural SA are home to 43.6% of the population, but are served by only 12% of doctors and 19% of nurses. Of the 1200 medical students graduating in the country annually, only about 35 work in rural areas in the long term. There are 30 generalists and 30 specialists/100 000 people in urban areas, compared to an average of 13 generalists and two specialists/100 000 people in rural areas. The question arises whether the poorer access to particularly specialist services is a contributing factor towards poorer outcomes. Specialist outreach to rural communities is one way of improving access to care. In the Eden and Central-Karoo districts of the Western Cape of SA there are one level 2 (regional) hospital and ten level 1 (district) hospitals. All clinical disciplines reach out, with varying frequencies. On average, the four main district hospitals receive 17 specialist outreach visits per month; while the smaller district hospitals receive three specialist visits per month (Appendix 1). A typical outreach visit includes a problem ward round, outpatient session, theatre list for some surgical disciplines and formal/informal educational sessions. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary, as it improves access to specialized health care services. In practise however, there are factors that influence whether or not O&S reaches its goals. This in turn affects the sustainability of O&S projects. Understanding these factors would aid recommendations for a suitable model for O&S.

Made available in DSpace on 2015-05-14T12:47:17Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 609832 bytes, checksum: fdd73debf3e835dd56305913d52d9a88 (MD5) Previous issue date: 2013-12-03 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The stroke is characterized by generate impairments that lead to high morbidity in the affected people. The stroke s impacts have their effects minimized through the implementation of a rehabilitation program. However, the care integrality to people who require this service is not yet secured, which is visible by the repressed demand to access to them existing in the health care network. The aim of this study is propose a model to assist the decision making process related to the need forwarding of patients affected by the stroke for rehabilitation services of João Pessoa PB. A cross-sectional observational study involving individuals diagnosed with stroke, with onset time not exceeding 60 months and linked to the Family Health Strategy. It was used a questionnaire containing items that contemplate the access to rehabilitation treatment, beyond the dimension Body Functions of International Classification of Functioning, Disability and Health (ICF). To make the use of ICF applicable some items were elected as reference, from the Core sets of stroke. The statistical method of logistic regression was used to subsidize the decision making from the functionality. The Body Functions that showed statistical significance (p-value < 0,05) were: Functions related to Muscular Tonus (OR = 2,38); Functions related to Voluntary Control (OR = 2,60); Emotional Functions (OR = 2,22); Sexual Functions (OR = 3,92). The results of this study show a valid logistic model, revealing the functional aspects correlated with the need for rehabilitation in post-stroke, enabling the decision making in this context. / O Acidente Vascular Encefálico (AVE) caracteriza-se por gerar incapacidades que levam a altos índices de morbidade nas pessoas acometidas. Os impactos do AVE têm seus efeitos amenizados mediante a realização de um programa de reabilitação. No entanto, a integralidade da assistência às pessoas que necessitam desse serviço ainda não está assegurada, o que é visível pela demanda reprimida de acesso aos mesmos existente na rede assistencial. O objetivo deste estudo é propor um modelo para auxiliar a tomada de decisão relacionada à necessidade de encaminhamento dos pacientes acometidos por AVE para os serviços de reabilitação no município de João Pessoa - PB. Trata-se de um estudo observacional de corte transversal, envolvendo indivíduos com diagnóstico de AVE, com tempo de acometimento não superior a 60 meses e vinculados à Estratégia de Saúde da Família (ESF). Foi utilizado um questionário contendo itens que contemplam o acesso ao tratamento de reabilitação, além da dimensão Funções do Corpo da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Para tornar o uso da CIF exequível elegeram-se alguns itens como referência, a partir do Core sets do AVE. O método estatístico de regressão logística foi utilizado para subsidiar a tomada de decisão a partir da funcionalidade. As Funções do corpo que apresentaram significância estatística (p-valor < 0,05) foram: Funções relacionadas ao Tônus Muscular (OR = 2,38); Funções relacionadas ao Controle Voluntário (OR = 2,60); Funções Emocionais (OR = 2,22); e Funções Sexuais (OR = 3,92). Os achados deste estudo apresentam um modelo logístico válido, revelando o quadro funcional que se correlaciona com a necessidade de reabilitação no pós-AVE, orientando, assim, a tomada de decisão neste contexto.

Made available in DSpace on 2015-05-14T12:47:19Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 3269699 bytes, checksum: af9285a2857f32a228efc8a34c2c80c4 (MD5) Previous issue date: 2014-12-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / In view of the Primary Health Care in Brazil has been strengthened, mainly, with the new National Primary Care Policy (PNAB), the Brazilian Ministry of Health has created the Program of Improving Access and Quality of Primary Care (PMAQ-AB) that aimed to improve healthcare public service quality and to enhance the Brazilian qualified health services within the SUS (Brazil's Unified Public Health System). By using the Module III of the external evaluation instrument from the 1º cycle of PMAQ-AB, which contains a lot of information on perception and satisfaction of public health services users regard to their access and usage, this present work aims to identify, considering statistical tools, the main factors that influence the user satisfaction of health services in Brazil and in its regions in order to develop decision models to help health public officers to define actions that increase health service quality and to make effective decisions. In this way, this work was carried out considering secondary data from the 1º cycle of PMAQ-AB, which takes place from 2012 to the first half of 2013. It was obtained a descriptive analysis, a cluster analysis to find the dependent variable of user satisfaction and logistic regression was applied in order to obtain decision models for Brazil and its regions. As a result, the main factors associated with user satisfaction on the provided health service for Brazil and its regions were obtained. Considering the results on Brazil as a whole, the achieved main factors were the following: the users perception on the health care unit staff on not solving their health needs (OR = 0.39) and the user does not (OR = 0.44) feel respected by health professionals in relation to their cultural habits, customs, religion or feel it only a few times (OR = 0.49). It was also noticed that the factors that influence the user satisfaction vary according to the considered region of Brazil due to mainly its diversity. Beyond the factors observed in Brazil, the following factors were also noted in its regions: the health unit time table does not meet the user needs, the users cannot be served when they are in the health care unit unless an previous appointment and the users have difficult to make complaints or suggestions in the health care unit. It was concluded that it is important that health care unit staff and managers try to improve health care unit access, to serve the user needs, to improve organization, and especially to strengthen the link of users and health professionals, in addition to home visits, considering socio-geographic and socioeconomic aspects. / Na perspectiva que a Atenção Básica à Saúde no Brasil vem se fortalecendo, principalmente com a Política Nacional de Atenção Básica (PNAB), o Ministério da Saúde criou o Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) visando a melhoria da qualidade do atendimento e a ampliação da oferta qualificada dos serviços de saúde no âmbito do SUS. Utilizando o Módulo III do instrumento de avaliação externa do 1° Ciclo do PMAQ-AB, que contém informações sobre a percepção e a satisfação dos usuários quanto aos serviços de saúde no que se refere ao seu acesso e utilização, este trabalho teve como objetivo analisar os principais fatores que influenciam na satisfação dos usuários dos serviços de saúde no Brasil e em suas regiões a fim de elaborar um modelo de suporte à decisão que auxilie o gestor em saúde na tarefa de definir ações promotoras que incrementem a qualidade dos serviços de saúde na percepção dos usuários e assim tomar decisões efetivas que fortaleçam essas ações. Para isso, foi realizado um estudo com dados secundários, produzidos pelo Ministério da Saúde, do 1º Ciclo de Avaliação Externa do PMAQ-AB realizado entre o ano de 2012 e o primeiro semestre de 2013. Dessa forma, realizou-se uma análise descritiva, uma análise de agrupamento para obter a variável dependente de satisfação do usuário e foi utilizada regressão logística para obtenção de modelos de decisão para o Brasil e suas regiões. Como resultado do estudo realizado, foram encontrados os principais fatores associados à satisfação do usuário com o serviço de saúde tanto para o Brasil quanto para cada um de suas regiões. Para o Brasil, os fatores em destaque foram: a percepção do usuário quanto a equipe não buscar resolver suas necessidades/problemas na própria unidade de saúde (OR = 0,39) e o usuário não (OR = 0,44) sentir-se respeitado pelos profissionais em relação aos seus hábitos culturais, costumes, religião ou sentir-se apenas algumas vezes (OR = 0,49). Devido à diversidade do país, observa-se também que os fatores influenciadores da satisfação do usuário variam de acordo com a região geográfica, destacando-se: o horário de funcionamento da unidade não atender às necessidades dos usuários; o usuário não conseguir ser escutado quando vem à unidade de saúde sem ter hora marcada para resolver qualquer problema; e a dificuldade de conseguir fazer uma reclamação ou sugestão na unidade de saúde. Conclui-se que é importante que equipes e gestores continuem empenhando seus esforços para melhorar a qualificação do acesso, atendam às necessidades dos usuários, melhorem os aspectos da organização e da dinâmica do processo de trabalho e, principalmente, fortaleçam o vínculo mediante o aprimoramento da relação entre usuários e profissionais de saúde, além das visitas domiciliares, considerando também a contribuição e a importância de análises de aspectos sócio geográficos e socioeconômicos.

Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2013-04-17T13:42:49Z No. of bitstreams: 1 Osmir Globekner.pdf: 950469 bytes, checksum: 619fda4d9d7b21142f45d4020e884351 (MD5) / Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-05-09T17:31:08Z (GMT) No. of bitstreams: 1 Osmir Globekner.pdf: 950469 bytes, checksum: 619fda4d9d7b21142f45d4020e884351 (MD5) / Made available in DSpace on 2013-05-09T17:31:08Z (GMT). No. of bitstreams: 1 Osmir Globekner.pdf: 950469 bytes, checksum: 619fda4d9d7b21142f45d4020e884351 (MD5) Previous issue date: 2009 / A presente dissertação desenvolvida na área de concentração de direito público e na linha de pesquisa de cidadania e efetividade de direitos ocupa-se do tema do acesso social à atenção sanitária como garantia da efetividade do direito à saúde. Aborda o problema específico dos mecanismos de alocação social dos recursos escassos necessários à consecução das prestações públicas e privadas de atenção sanitária buscando a aproximação entre os discursos liberal e social nas respectivas defesas dos mecanismos de alocação pelo mercado e pelo planejamento público. Inicialmente especifica-se o conteúdo dos conceitos de saúde e de direito à saúde e alguns aspectos relevantes a eles relacionados tais como: as relações entre a inovação tecnológica em saúde e a desigualdade social a natureza das necessidades humanas no campo sanitário as circunstâncias político-sociais em torno da constitucionalização do direito à saúde e a forma como se orientou a proteção jurisdicional desse direito no Brasil. Em seguida trata-se da questão da racionalidade econômica na alocação dos recursos sociais escassos o que é feito partindo-se da discussão sobre o custo dos direitos encetada por Stephen Holmes e Cass Sunstein nos Estados Unidos da América e sua aplicação no contexto brasileiro conforme abordagem de Gustavo Amaral e Flávio Galdino. Associa-se também tal discussão à questão das decisões trágicas de acordo com a doutrina exposta por Guido Calabresi e Philip Bobbitt. Aborda-se na sequência a concepção histórica dos paradigmas liberal e social à luz de suas relações com os direitos fundamentais. O aprofundamento da análise dos fundamentos da igualdade é feito separadamente em cada um dos dois modelos paradigmáticos de alocação social de recursos escassos o liberal e o social. No paradigma liberal a discussão toma por base fundamentalmente a doutrina da “justiça como equidade” de John Rawls e a oposição que lhe é feita por seus críticos em especial Robert Nozick e Amartya Sen extraindo-se ainda dessa discussão os limites da igualdade dentro do referido paradigma. No campo da fundamentação da igualdade no paradigma social estudam-se os fundamentos e as características da igualdade com base no reconhecimento dos direitos fundamentais sociais a distinção entre igualdade formal e igualdade material e os limites desta os limites imanentes associados à questão da identidade e multiplicidade cultural e social os externos determinados pela limitação dos recursos materiais. Aborda-se aí o tema da reserva do possível e do mínimo existencial no campo sanitário. Por fim apontam-se os elementos comuns e convergentes que orientam uma uniformidade de critérios visando à constituição do que se convencionou denominar “justiça distributiva sanitária”, como instrumento da promoção do acesso social igualitário aos bens sociais e serviços de saúde e as possibilidades de construção desses princípios dentro do sistema de atenção à saúde concebido no Brasil pela Constituição Federal de 1988 como um sistema dual público e privado. Conclui-se pela necessidade da constante construção reconstrução e fortalecimento de princípios que orientem o acesso equitativo aos bens e serviços relacionados com a saúde nos âmbitos privado e público. / Salvador

This study explored how the well-being of the gays, lesbians and bisexuals (GLBs} in Botswana could be promoted. The health and human rights approach that places dignity before rights was selected as a framework for investigation. The respondents' (n=47) levels of well-being were assessed through a questionnaire with 76 items that included the General Well-Being Schedule. The findings indicated that varying degrees of distress were experienced by 64 % of the GLBs in this study. The GLBs identified a need for HIV/AIDS education and had concerns about their general health, discrimination and vulnerability for violence including sexual attacks. Their levels of well-being were influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Levels of involvement of health professionals was poor, and linkage between health and human rights was proposed to reduce dignity violations and improve the quality of life of the GLBs in Botswana. / Health Studies / M.A. (Nursing Science)

Inequalities in levels of health between regions within a country are frequently regarded as a problem. Zimbabwe is characterised by poor and unequal conditions of health (both the state of people’s health and health services). The health system of the country shows severe spatial inequalities that are manifested at provincial, district and even local levels. This research therefore examines and analyses the spatial inequalities and temporal variation of health conditions in Zimbabwe. Composite indices were used to determine the people’s state of health in Zimbabwe. Administrative districts were ranked according to the level of people’s state of health. Cluster analysis was also performed to demarcate administrative districts according the level of health service provision. Districts with minimum difference were demarcated in a single cluster. Clusters were delineated using data on patterns of diseases and health and such clusters were used to demarcate the country’s spatial health system according to the Adapted Epidemiological Transition Model. This was used to evaluate the applicability of the model to Zimbabwe. It emerged from the research that generally the country’s health conditions are poor and the health system is characterised by severe spatial inequalities. Some districts are experiencing poor health service provision and serious health challenges and are still in the age of pestilence and famine but others have good health service provision as well as highly developed health conditions and are in the age degenerative diseases of the epidemiological transition model. It further emerged that the country’s health has been evolving with signs of improvement since the 1990s. Recommendations were made regarding possible adjustment to previous strategies and policies used in Zimbabwe, for the development of the health system of the country. New strategies were also recommended for the improvement of the health system of the country. Some proposals are made for further research on the spatial development of health in the country. / Geography / D. Litt et. Phil. (Geography)

O sistema de saúde vem se transformando pressionado por mudanças sociodemográficas, políticas e econômicas. Essas modificações impõem aos gestores a necessidade de conhecer de maneira particularizada o perfil de demandas da população usuária. Neste contexto, o presente estudo tem por objetivo identificar o padrão e as características de utilização de um serviço de atenção primária à saúde a nível ambulatorial. Como objetivos específicos buscou-se traçar o perfil sociodemográfico dos usuários de unidades de APS, avaliar os motivos das consultas, identificar o tipo de atendimento utilizado e a categoria profissional responsável pelo atendimento, avaliar a relação das consultas com as ações programáticas desenvolvidas nos serviços de saúde e identificar a associação entre a vulnerabilidade da área de moradia e os motivos de consulta. Foi realizado um estudo transversal com dados retrospectivos do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição (SSC-GHC). A fonte primária foi o Boletim de Atendimento(BA), emitido para cada consulta efetuada no período de 1/01/2011 a 31/12/2011. O total de consultas avaliadas foi de 34.014 realizadas em duas unidades da Zona Norte de Porto Alegre por profissionais de nível superior de diferentes categorias profissionais. . A fonte primária do banco de dados foi o BA, emitido para cada atendimento ambulatorial. A análise dos dados foi feita com o programa estatístico SPSS versão 18.0. A análise descritiva respeitou as características e a distribuição das variáveis. As variáveis contínuas e com distribuição normal foram descritas por meio da média e desvio padrão e as variáveis contínuas e sem distribuição normal foram apresentadas como mediana (intervalo interquartil). As variáveis categóricas foram descritas como números absolutos. O número total de consultas efetivadas foi de 34.014, realizadas por 5.033 pessoas com cadastro nas unidades. A participação de moradores de área de risco foi de 31,3%. O número de pessoas consideradas hiperutilizadores - com mais de 6 consultas/ano - foi de 2.216 (44%). Os hiperutilizadores realizaram 78% das consultas. Estavam presentes hiperutilizadores em 53,7% das famílias. Os hiperutilizadores tinham como característica predominante ser mulher (67,8%), pertencer à faixa etária dos 20 aos 49 anos ou de mais de 60 anos. Os problemas relacionados à saúde mental e comportamental têm um percentual mais elevado entre os usuários hiperutilizadores, (6,9% vs 3,5%). O profissional mais procurado foi o médico (59,3%) seguido pelo odontólogo (27,5%). Os motivos de consulta encontrados são semelhantes no grupo de hiperutilizadores e não hiperutilizadores e distribuídos dentro do esperado para as faixas etárias. / The health system has been undergoing transformation due to sociodemographic, political and economic changes. These alterations impose to managers the need to individually know the demand profile of the user population. In this context, the present study aims to identify the use pattern and characteristics in primary health care service at ambulatorial level. As for specific objectives, this research intended to develop the sociodemographic profile of Primary Health Care (PHC) units users, evaluate the reasons for consultations, identify the type of service utilized and the professional category responsible for providing the service, assess the relationship between consultations and the programmatic actions performed by health services as well as to identify the association between the vulnerability of the housing area and the reasons for consultation. A cross-sectional study was conducted with retrospective data from the Community Health Service of the Conceição Hospital Group (SSC-GHC). The primary source was the outpatients' charts issued for each consultation in the period between 1/1/2011 and 12/31/2011. The study comprised a total of 34,014 consultations performed in two units of the North Region of Porto Alegre by professionals with tertiary education from different occupational categories. The main objective of this study was to identify use pattern and characteristics of primary health care services at ambulatorial level. The specific objectives were to develop the sociodemographic profile of PHC units users, evaluate the reasons for consultations, identify the type of service utilized and the professional category responsible for providing the service, assess the relationship between consultations and the programmatic actions performed by health care services as well as to identify the association between the vulnerability of the housing area and the reasons for consultation. The primary source of the database was the chart issued for each outpatient’s ambulatory care. The data analysis was realized with the SPSS statistics software version 18.0. The descriptive analysis considered the characteristics and distribution of variables. The continuous variables with normal distribution were described through averages and standard deviation whilst the continuous variables without normal distribution were presented as median (interquartile range). Categorical variables were described as absolute numbers. The total number of consultations was 34,014 referring to 5,033 people registered in the units. The participation of risk area residents was 31.3%. The number of people considered frequent users - with more than 6 consultations per year - amounted to 2,216 (44%). The frequent users accounted for 78% of the consultations. They were present in 53.7% of households. Frequent users were predominantly women (67.8%), belonging to the age group ranging from 20 to 49 years old or over 60. Mental and behavioral health related issues have a higher percentage among frequent users (6.9% vs. 3.5%). The most requested professional was the physician (59.3%) followed by the odontologist (27.5%). The reasons for consultation found are similar in both frequent and non-frequent users and distributed within the expected for the age groups.