**Abstract**

The objective of the research was to analyze the factors associated with the use of health services by elderly men in the Northeast region of Brazil. Cross-sectional analytical study with a secondary database of elderly men (n = 3238). The dependent variable was composed of the profiles of the use of health services and the independent variables were factors of predisposition, capacity, and health need. The statistical association and effect were performed using the Rao-Scott test with p < 0.05 and multinomial logistic regression. Elderly men with worse social indicators had a risk effect for using medium/high complexity services and those who had better health indicators were associated with sporadic medical appointment, revealing that healthcare for elderly men is centered on curative and rehabilitative care and that the use of health services is associated with the worst social indicators.

**Keywords:** Health Services, Health of the Elderly, Men's Health, Cross-Sectional Studies

#### **1. Introduction**

The demographic transition is marked by a reduction in fertility and mortality and results, along with the epidemiological transition, in population aging. According to United Nations projections, the elderly population in Brazil will increase from 3.1% in 1970 to 19% in 2050. The increase in the elderly population generates the need for a new social, economic and health organization [1].

In this sense, it is observed that the elderly are major users of health services [2] and that this use has increased in recent years [3, 4]. Although in Brazil the National Health Policy for the Elderly and the National Policy for Comprehensive Care to Men's Health (PNAISH, in Portuguese) have been instituted which aim to organize, implement, qualify and humanize comprehensive healthcare for the elderly and the men, respectively, the demand for health services by this public are still low.

The use of health services represents the center of the health systems functioning and comprises all direct or indirect contact with health services. This process

results from the interaction of the individual's behavior who seeks for care and the professional who leads him within the health system [5].

Andersen [6], in his classic model for the use of health services [7], points out the influence of access in the use of health services as mediated by individual factors, defined as predisposing factors (those that exist before the emergence of the health problem and affect the predisposition of people to use the services), enabling factors (the means available to obtain healthcare) and health needs (the health conditions perceived by people or diagnosed by health professionals).

Several studies show that men, in general, have more severe and chronic diseases than women [8–10]. Despite male rates responding significantly in the morbidity and mortality data, the presence of men in primary health care services is lower than that of women [11, 12] and although there is a wide discussion about masculinity in the health area, with research that refers to the need to reflect on this topic addressing to understand the risks to men's health [8, 13–16], there are few studies that explore the use of health services by elderly men and the associated epidemiological and socioeconomic factors.

Such data scarcity occurs especially in the Northeast of Brazil, a socioeconomically unequal region comparing to other regions of the country [17], making it necessary to analyze the theme. Thus, the present study analyzed the factors associated with the use of health services by elderly men in the Northeast region of Brazil.
