THE THE UNIFIED HEALTH SYSTEM AND ITS ACCESS BARRIERS: AN INTEGRATIVE LITERATURE REVIEW

Abstract

The 1988 Federal Constitution defines health as a universal right and a responsibility of the State, to be guaranteed through policies aimed at reducing risks and health-related harms. Within this framework, the Unified Health System (SUS) was created as a proposal for broad and equitable access; however, public confidence in the system remains limited, leading many individuals to seek private healthcare alternatives, often at high cost. Accordingly, this study aims to examine, in national and international literature, the main barriers that hinder access to SUS. Considering this context, an integrative literature review was conducted. The analysis included primary studies published between 2015 and 2025, in English, Portuguese, and Spanish, that addressed obstacles related to healthcare access. Eight studies published between 2016 and 2023 were identified, highlighting issues such as discrimination, social exclusion, structural deficiencies, organizational limitations, and geographic challenges. Overall, although SUS represents an essential universal public health policy, its full effectiveness remains constrained by persistent inequalities that hinder equitable access and underscore the need for system-strengthening strategies.