A funcionalidade como indicador de saúde: dados de inquérito de saúde do Chile

Abstract

In recent decades, the World Health Organization (WHO) has encouraged the collection of information on how a person's health status manifests in their daily life, recognizing the importance of the lived experience of health, in addition to mortality and morbidity data, for public health. Functioning is a complex measure that encompasses the domains of biological health, health experiences, and activity performance, considering both an individual's intrinsic capacity and environmental characteristics. Therefore, functioning has been suggested as a health indicator. Objectives: The specific objective was to discuss the possibility of using functioning as a health indicator, using data from a health survey that employed the Model Disability Survey (MDS) instrument. Methods: Observational studies were conducted using secondary data from II Estudio Nacional de la Discapacidad - ENDISC, a population survey conducted in Chile in 2015. The adult population was the focus of the studies, using data from 12,265 people. Capacity and performance variables, derived from the functioning block of the MDS, were expressed as scores ranging from 0 to 100. Sociodemographic information and health conditions were also collected. Descriptive analyses were performed using means and frequencies, with their respective 95% confidence intervals. Generalized linear models (GLM) with logarithmic link and gamma distribution to measure differences between categories of explanatory variables of outcomes due to the distribution of variables were used. The analyses were conducted using Stata 11. Results: The results are presented in 5 articles. It was possible to identify that functioning as a indicator expresses different health perspectives when compared to mortality and morbidity. It was also identified that sociodemographic factors such as gender, age, education, and income influence performance and capacity indices, suggesting the need for a comprehensive approach in health policies. Additionally, it was possible to observe that individuals with chronic diseases presented worse levels of functioning. Conclusion: Including data collection on functioning in health surveys can provide management with an indicator that contributes to improving understanding of the population's health, directing resources more effectively, and promoting a more equitable approach in the provision of health services, aligning with sustainable development goals and WHO proposals.