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.
Artículo
en Inglés
| Coleciona SUS
| ID: biblio-945455
Biblioteca responsable:
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:
Disponible
Colección:
Bases de datos nacionales
/
Brasil
Contexto en salud:
Agenda de Salud Sostenible para las Américas
/
ODS3 - Salud y Bienestar
Problema de salud:
Objetivo 6: Sistemas de información para la salud
/
Meta 3.8: Alcanzar cobertura universal de salud
Base de datos:
Coleciona SUS
Asunto principal:
Atención Primaria de Salud
/
Estrategias de Salud Nacionales
/
Indicadores de Salud
/
Acceso Universal a los Servicios de Salud
Tipo de estudio:
Estudio de etiología
/
Factores de riesgo
Aspecto:
Determinantes sociales de la salud
/
Investigación de implementación
/
Preferencia del paciente
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
PLos ONE
Año:
2018
Tipo del documento:
Artículo
Institución/País de afiliación:
Federal University of Minas Gerais/BR
/
Harvard T.H. Chan School of Public Health/US
/
University of São Paulo/BR