Transition to universal primary health care coverage in Brazil: analysis of uptake and expansion patterns of Brazils Family Health Strategy (1998-2012)
PLos ONE
; 13(8)2018.
Artigo
em Inglês
| Coleciona SUS
| ID: biblio-945455
Biblioteca responsável:
BR1.1
ABSTRACT
Family Health Strategy, the primary health care program in Brazil, has been scaled up throughout the country, but its expansion has been heterogeneous across municipalities. We investigate if there are unique municipal characteristics that can explain the timing of uptake and the pattern of expansion of the Family Health Strategy from years 1998 to 2012. We categorized municipalities in six groups based on the relative speed of the Family Health Strategy uptake and the pattern of Family Health Strategy coverage expansion. We assembled data for 11 indicators for years 2000 and 2010, for 5,507 municipalities, and assessed differences in indicators across the six groups, which we mapped to examine spatial heterogeneities. Important factors differentiating early and late adopters of the Family Health Strategy were supply of doctors and population density. Sustained coverage expansion was related mainly to population size, marginal benefits of the program and doctors supply. The uptake was widespread nationwide with no distinct patterns among regions, but highly heterogeneous at the state and municipal level. The Brazilian experience of expanding primary health care offers three lessons in relation to factors influencing diffusion of primary health care. First, the funding mechanism is critical for program implementation, and must be accompanied by ways to support the supply of primary care physicians in low density areas. Second, in more developed and bigger areas the main challenge is lack of incentives to pursue universal coverage, especially due to the availability of private insurance. Third, population size is a crucial element to guarantee coverage sustainability over time.
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Objetivo 6: Sistemas de informação em saúde
/
Meta 3.8 Atingir a cobertura universal de saúde
Base de dados:
Coleciona SUS
Assunto principal:
Atenção Primária à Saúde
/
Estratégias de Saúde Nacionais
/
Indicadores Básicos de Saúde
/
Acesso Universal aos Serviços de Saúde
Tipo de estudo:
Estudo de etiologia
/
Fatores de risco
Aspecto:
Determinantes sociais da saúde
/
Pesquisa de implementação
/
Preferência do paciente
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
PLos ONE
Ano de publicação:
2018
Tipo de documento:
Artigo
Instituição/País de afiliação:
Federal University of Minas Gerais/BR
/
Harvard T.H. Chan School of Public Health/US
/
University of São Paulo/BR