[Household surveys as an evaluation tool for health services: a case study from the Southeast region of the Greater São Paulo Metropolitan Area, 1989-1990]

The increasing importance of health evaluation has raised the need of incorporating epidemiological methodology to assess both technologies and health services. Evaluation of health services performance requires population data to identify the unmet demand and patterns of health services utilization. Such data can be obtained through household surveys. A household survey in the Greater São Paulo Metropolitan Area identified the pattern of health services utilization by the local population. This pattern, which reflects current organization of health services, pointed to a low coverage level by local services, including public clinics, different profiles for users of private and public services, and a large demand for health services outside the area, mainly for childbirth. The information obtained through these surveys produces a "base line" for health planning and further evaluation and is central to the assessment of existing services. The advantages of household surveys in health services evaluation should be analyzed in relation to the potential use of such data and study costs, thereby designing the best cost-benefit relationship for each specific situation.