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Transition to universal primary health care coverage in Brazil: analysis of uptake and expansion patterns of Brazil’s Family Health Strategy (1998-2012)
Andrade, Monica Viegas; Coelho, Augusto Quaresma; Xavier Neto, Mauro; Carvalho, Lucas Resende de; Atun, Rifat; Castro, Marcia C.
Afiliación
  • Andrade, Monica Viegas; Federal University of Minas Gerais. Center for Development and Regional Planning. Belo Horizonte. BR
  • Coelho, Augusto Quaresma; University of São Paulo. Faculty of Medical Sciences. São Paulo. BR
  • Xavier Neto, Mauro; University of São Paulo. Faculty of Medical Sciences. São Paulo. BR
  • Carvalho, Lucas Resende de; Federal University of Minas Gerais. Center for Development and Regional Planning. Belo Horizonte. BR
  • Atun, Rifat; Harvard T.H. Chan School of Public Health. Department of Global Health and Population. Boston. US
  • Castro, Marcia C; Harvard T.H. Chan School of Public Health. Department of Global Health and Population. Boston. US
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.
Asunto(s)

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

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
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