A reappraisal in São Paulo, Brazil (2008) of "The Ecology of Medical Care:" The "One Per Thousand's Rule".

Background And Objectives: Medical ecology is a conceptual framework introduced in 1961 to describe the relationship and utilization of health care services by a given population. We applied this conception to individuals enrolled in a private health maintenance organization (HMO) in Sao Paulo, Brazil, with the aim of describing the utilization of primary health care, verifying the frequency of various symptoms, and identifying the roles of different health care sources.

Methods: This was a cross-sectional telephone survey among a random sample of people enrolled in a private HMO.