Influence of the Mais Médicos (More Doctors) Program on health services access and use in Northeast Brazil.

Autor:	Gonçalves RF; Doutorado em Saúde Pública, Instituto Aggeu Magalhães, IAM/Fiocruz-PE. Recife, PE, Brasil.; Universidade de Pernambuco Campus Petrolina, Colegiado de Fisioterapia. Petrolina, PE, Brasil., Bezerra AFB; Universidade Federal de Pernambuco, Departamento de Medicina Social, Centro de Ciências da Saúde. Recife, PE, Brasil., Tanaka OY; Universidade de São Paulo, Faculdade de Saúde pública, Departamento de Prática de Saúde Pública. São Paulo, SP, Brasil., Santos CRD; Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Núcleo de Saúde Coletiva. Vitória de Santo Antão, PE, Brasil., Silva KSBE; Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Núcleo de Saúde Coletiva. Vitória de Santo Antão, PE, Brasil., Sousa IMC; Instituto Aggeu Magalhães, IAM/Fiocruz-PE. Recife, PE, Brasil.
Jazyk:	English; Portuguese
Zdroj:	Revista de saude publica [Rev Saude Publica] 2019 Dec 09; Vol. 53, pp. 110. Date of Electronic Publication: 2019 Dec 09 (Print Publication: 2019).
DOI:	10.11606/S1518-8787.2019053001571
Abstrakt:	Objective: To evaluate the influence of the Mais Médicos (More Doctors) Program on the performance of primary health care by quantifying health services access and use in Northeast Brazil, based on the population size of the municipalities, on the financial investment in health, and on the number of physicians in the family health teams. Method: Evaluative research of quantitative nature. Access was evaluated by the population coverage ratio of the Family Health Strategy and use of health services, which were measured by medical appointments conducted between April 2013 and September 2015. We defined processes for database selection, adjustment, and validation, including explanatory variables for a sample of 896 municipalities. The analysis was based on the time periods before and after the implementation of the program. The Wilcoxon signed-rank test and non-parametric alternatives constituted statistical tests in the comparative analysis of the data. Results: A 19.2% increase was observed in the number of medical appointments between the first six months and the final six months of the data series. In this period, the median appointments in municipalities with up to 5,000 inhabitants increased from 701.0 to 768.0; while in those with more than 100,000 inhabitants it decreased from 285.5 to 280.0 (p < 0.05). Between April 2013 and September 2015, the median coverage ratio of the family health teams increased from 89.2% to 95.3%, approaching 100% in the municipalities with up to 20,000 inhabitants. Conclusions: The study highlights the expansion of access and use of primary health care services in the northeast region after the implementation of the Mais Médicos (More Doctors) Program. Between April 2013 and September 2015, the coverage of family health teams and the production of medical appointments increased, constituting important achievements for SUS.
Databáze:	MEDLINE
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