Avaliação do escopo de prática de médicos participantes do Programa Mais Médicos e fatores associados

Girardi, Sabado Nicolau; Carvalho, Cristiana Leite; Pierantoni, Célia Regina; Costa, Juliana de Oliveira; Stralen, Ana Cristina de Sousa van; Lauar, Thaís Viana; David, Renata Bernardes

doi:10.1590/1413-81232015219.15912016

Cited by 24 publications

(43 citation statements)

References 13 publications

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“…A study developed with active professionals in the Programa Mais Médicos (PMM) (More Physicians Program) demonstrated that working in the geographic North region is a factor that contributes to the accomplishment of a great quantity of procedures. 2 In contrast, the Northeast region is the one that performs a lesser quantity of procedures, according to the data in this study.…”

Section: Discussionsupporting

confidence: 53%

“…This relation between a expanded scope of practice of physicians and their work in rural and remote areas have been identified in several studies. 2,20,21 Despite that it was not so evident in the nursing professionals, it is suggestive that a nurse who works in a rural unit of a riveside community, with only fluvial access, in Entorno de Manaus, performs more procedures than others interviewed in the same region.…”

Section: Discussionmentioning

confidence: 99%

“…22 In relation to far away cities, the study by Girardi et al 2 showed that professionals in these locations perform a great number of procedures.…”

Section: Discussionmentioning

confidence: 99%

“…1 From this perspective, the scope of practice is determined from the processes of interaction between the agents and the institutions, which include from the professional regulation, in other words, those activities authorized by law, the activities that the professional performs in practice and has competence to perform, considering both the skills gained through study and practice as on the individual's qualities and attitudes. [2][3][4] In the health area, the form how professional practice are defined, limited or extended, directly impacts the quality and cost of services. 5 On the other hand, the factors that determine these practices are different from what has been shown in several studies on the theme, in which the scope of health professionals has been associated, among others, to factors such as nationality, sex, age, education, experience and location of practice, such as remote and unassisted areas or with low availability of health professionals.…”

Section: Introductionmentioning

confidence: 99%

“…5 On the other hand, the factors that determine these practices are different from what has been shown in several studies on the theme, in which the scope of health professionals has been associated, among others, to factors such as nationality, sex, age, education, experience and location of practice, such as remote and unassisted areas or with low availability of health professionals. 2,[5][6][7] The Atenção Primária em Saúde (APS) (Primary Health Care) in several countries has gone through significant changes with respect to the number and types of health professionals and their roles in the health services. 8,9 Countries such as Australia, Canada, the United States and England are reviewing of the scope of health professions, seeking each time more in optimizing their workforce, reducing costs, providing greater equity and quality in service provision, mainly in regions that present shortage of these professionals.…”

Section: Introductionmentioning

confidence: 99%

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Scope of practice in Primary Care: physicians and nurses in five health regions in Brazil

Girardi

Stralen

Lauar

et al. 2017

Rev. Bras. Saude Mater. Infant.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

“…22 In relation to far away cities, the study by Girardi et al 2 showed that professionals in these locations perform a great number of procedures.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Scope of practice in Primary Care: physicians and nurses in five health regions in Brazil

Girardi

Stralen

Lauar

et al. 2017

Rev. Bras. Saude Mater. Infant.

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A integralidade das práticas dos médicos cubanos no Programa Mais Médicos na cidade do Rio de Janeiro, Brasil

2018

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The shortage of physicians in remote and underprivileged areas poses an obstacle to universal access and quality of health care. Through the More Doctors Program (PMM), as of 2015, 18 thousand physicians had been incorporated into Brazil's Unified National Health System (SUS) to work in basic care, 79% of whom were Cubans. This article analyzed the comprehensiveness of practices by Cuban physicians in the PMM using a qualitative study in the city of Rio de Janeiro, Brazil, based on interviews with Cuban physicians (24) and a focus group with supervisors of the PMM (4). Comprehensiveness was analyzed in two dimensions: the community-oriented biopsychosocial approach to care and the range of activities in health promotion, prevention, and care. The work by Cuban physicians presents elements that are consistent with the comprehensiveness of practices in primary care, providing a wide range of care and services, in keeping with the health problems' complexity and the plurality of settings. These health workers show outstanding capacity for community interaction, a preventive focus, planning of activities, and positive interpersonal team relations. The study identified attitudes and techniques of solidarity, physician-patient bonding, and community accountability. Challenges were identified in the promotion of participatory practices with communities, the expansion of users' autonomy in clinical decisions, management of psychological problems, systematization of approach tools, and performance of invasive procedures. The study furnishes strong evidence that the PMM, in addition to medical consultations, provides comprehensive health care and contributes to strengthening basic care in Brazil.

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A circularidade dos médicos em cinco regiões de São Paulo, Brasil: padrões e fatores intervenientes

Seixas

Ibañez

Silva³

et al. 2019

Cad. Saúde Pública

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O artigo objetiva analisar a movimentação dos médicos, sob nova perspectiva, verificando seu deslocamento e oferta de trabalho entre as Regiões de Saúde, especificamente em cinco regiões do Estado de São Paulo, Brasil. Denominou-se essa movimentação como circularidade médica, definida pela diversidade de vínculos constituintes do exercício profissional observada ao longo de um determinado período em determinados espaços geográficos. A metodologia usada foi de estudo de casos múltiplos com aplicação de abordagens quantitativas e qualitativas. Todos os médicos cadastrados na base do Cadastro Nacional de Estabelecimentos de Saúde (CNES), em março de 2015, foram categorizados em: “médicos exclusivos”, com vínculos exclusivamente na região em foco; e “médicos não exclusivos”, com vínculo na região e em outras. Analisaram-se os dados socioeconômicos e de saúde da região e a estrutura assistencial de saúde. A dependência regional de médicos externos variou de 30% a 40%, mais elevada nas regiões mais desenvolvidas e menor nas menos desenvolvidas. A dependência interna, entre municípios, fica próxima de 40% nas regiões com maior desenvolvimento econômico e chega a 60% nas as regiões menos desenvolvidas. Médicos não exclusivos são mais especializados, com maior atuação em especialidades cirúrgicas e de diagnóstico, e os exclusivos atuam mais em especialidades básicas e clínicas, indicando que a movimentação pode estar associada à organização da prestação da assistência, nos seus diferentes arranjos. Identifica-se uma crescente participação de arranjos terceirizados e a importância de ações pactuadas regionalmente. Tais estudos podem orientar melhor as políticas redistributivas mais integradas.

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Avaliação do escopo de prática de médicos participantes do Programa Mais Médicos e fatores associados

Abstract: Abstract

Cited by 24 publications

References 13 publications

Scope of practice in Primary Care: physicians and nurses in five health regions in Brazil

Scope of practice in Primary Care: physicians and nurses in five health regions in Brazil

A integralidade das práticas dos médicos cubanos no Programa Mais Médicos na cidade do Rio de Janeiro, Brasil

A circularidade dos médicos em cinco regiões de São Paulo, Brasil: padrões e fatores intervenientes

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