Propriedades de medida de um instrumento de avaliação de fatores determinantes do uso de serviços de saúde por pessoas idosas

Abstract

Population aging, coupled with the high prevalence of chronic diseases, poses an increasing challenge for health systems, particularly within Primary Health Care (PHC). Despite advances in Brazilian public policies, disparities in access to and utilization of services persist. In this context, there is a notable absence of theoretically grounded instruments capable of systematically assessing the determinants of service utilization by older adults. The Andersen Behavioral Model, which considers predisposing, enabling, and need-related factors, stands out as an appropriate framework for this type of investigation. Given these considerations, the aim of this study was to analyze the reliability and validity of the “Determinants of Health Services Use Among Older Adults (DUSSI) ” Questionnaire, theoretically anchored in the Andersen Model. A methodological study of measurement properties was conducted in two Basic Health Units in Juiz de Fora (MG), with 30 randomly selected older adults (≥60 years). Participants with cognitive deficits were excluded. Data collection took place in the home setting, utilizing the DUSSI questionnaire. Internal consistency, reliability, measurement error, and criterion validity were assessed. The questionnaire demonstrated high internal consistency (Cronbach’s alpha: 0.76 to 0.77), excellent reliability (overall ICC: 0.94 to 0.97), and acceptable measurement error. No evidence supporting criterion validity was observed. Thus, the study demonstrates that DUSSI provides robust evidence of internal consistency, reliability, and measurement error. Despite limitations related to sample size and the absence of a gold standard preventing the confirmation of criterion validity, this research offers original contributions and opens promising avenues for future investigations in larger populations.