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[Primary health care performance in Brazil and association with the More Doctors physician recruitment programCalidad de la atención primaria de salud en Brasil y relación con el Programa Más Médicos].
- Source :
-
Revista panamericana de salud publica = Pan American journal of public health [Rev Panam Salud Publica] 2018 Oct 04; Vol. 42, pp. e164. Date of Electronic Publication: 2018 Oct 04 (Print Publication: 2018). - Publication Year :
- 2018
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Abstract
- Objective: To assess the performance of primary health care (PHC) in Brazil and its association with the More Doctors Program (Programa Mais Médicos, PMM).<br />Method: This nationwide cross-sectional study used the Primary Care Assessment Tool validated for Brazilian Portuguese (PCATool-Brasil) to determine the achievement of PHC according to user experience associated with three physician categories: Brazilian physicians participating in the PMM, Cuban physicians participating in the PMM, and Brazilian physicians not linked to the PMM. The following PHC scores were calculated: overall PCA score, accessibility (first contact), and longitudinality. The association between PHC scores, physician category, and other user and physician characteristics was investigated using multilevel analysis.<br />Results: The overall PCA score for Brazil was 6.78, and the longitudinality score was 7.43. There was no difference in these scores among the three physician categories. The overall accessibility score was 4.24. A small but significant difference (P < 0.001) in accessibility score was detected among physician categories: 4.43 for Cuban physicians participating in the PMM (CI: 4.32-4.54), 4.08 for Brazilian physicians participating in the PMM(CI: 3.98-4.18), and 4.20 for Brazilian physicians not linked to the PMM (CI: 4.09-4.32). Age, socioeconomic level, presence of chronic diseases, and home visits by physicians positively influenced the overall PCA score on multilevel analysis.<br />Conclusions: The type of physician did not influence the primary care orientation (overall score) of the healthcare system in Brazil. PMM was associated with higher accessibility sores in more socioeconomically vulnerable areas. Multilevel analysis showed that PCH may be strengthened by the reinforcement of essential physician roles (such as home visits) and by improving access for socioeconomically vulnerable, younger populations or those without chronic diseases.<br />Competing Interests: Conflitos de interesse. Estudo proposto por pesquisadores do Programa de Pós-Graduação em Epidemiologia, da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS), e financiado pela Organização Pan-Americana de Saúde/Organização Mundial da Saúde (OPAS/OMS). Os autores declaram ter avaliado os dados conforme evidências, não havendo conflito de interesses.
Details
- Language :
- Portuguese
- ISSN :
- 1680-5348
- Volume :
- 42
- Database :
- MEDLINE
- Journal :
- Revista panamericana de salud publica = Pan American journal of public health
- Publication Type :
- Academic Journal
- Accession number :
- 31093192
- Full Text :
- https://doi.org/10.26633/RPSP.2018.164