Association between diagnosis of depression and health service coverage: a multilevel analysis of the National Health Survey, Brazil, 2019

OBJECTIVE: To analyze association between prevalence of diagnosis of depression in adults and health service coverage in Brazil's Federative Units. METHODS: This was a cross-sectional study using data from the 2019 National Health Survey. Adjusted odds ratios (OR) and 95% confidence intervals (95%CI) were calculated from multilevel logistic regression models to analyze association between diagnosis of depression and health service coverage. RESULTS: 88,531 adults residing in the 27 Brazilian Federative Units were analyzed in 2019. Higher odds of depression diagnosis were found among adults residing in Federative Units with greater Family Health Strategy coverage (OR 1.35; 95%CI 1.29; 1.42), with a greater number of family health support centers (OR 1.17; 95%CI 1.13; 1.21) and psychosocial care centers (OR 1.31; 95%CI 1.23; 1.41). CONCLUSION: The results of this study indicated that greater health service coverage was associated with higher prevalence of diagnosis of depression. These findings emphasized the importance of expanding and strengthening the psychosocial care network to improve diagnosis and care of individuals with mental disorders in Brazil.