Atenção Primária à Saúde nos municípios brasileiros: eficiência e disparidades

David, Grazielle Custódio; Shimizu, Helena Eri; Silva, Everton Nunes da

doi:10.5935/0103-1104.2015s005512

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…As for the comparison between PSMind and IDSUS, it is observed that Groups 5 and 6, formed by poorer municipalities and with less technologically dense health services [51], have a lower prevalence (56.6% and 71.5%, respectively) of PSMind in an adequate situation when in comparison with the municipalities in Group 1. The municipalities in Groups 3 and 4 also demonstrate a lower prevalence (52.3% and 85.7%, respectively) of adequate PS management capacity, but in comparison with the municipalities in Group 5.…”

Section: Resultsmentioning

confidence: 98%

“…Despite the various strategies to improve PHC nancing and investment in training [18], it is known that Brazilian municipalities face diverse types of di culties, especially small ones, because they do not have enough own resources to nance expenses not covered by the federal government [20,51]. Besides, the health service network is insu cient and there is di culty in maintaining human resources in small municipalities [51,58,59].…”

Section: Discussionmentioning

confidence: 99%

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Pharmaceutical Services Management Capacity and the Municipal Socioeconomic Scenario: Persistent Inequalities

Faraco

Rover

Cunha

et al. 2023

Preprint

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Background Although access to essential medicines means resolution for most health conditions in primary health care, ensuring it is still a complex challenge for all health systems. Recent studies show that fair access to medicines must be determined by health care needs, considering the variables in the socioeconomic environment. In this context, despite advances, weaknesses in the development of pharmaceutical services persist, strongly related to management capacity. The study investigates the relationship between the management capacity of Pharmaceutical Services and socioeconomic indices in Brazilian municipalities, analysing which contextual factors are involved in its development.Methods Data from a cross-sectional exploratory study at national scale and indicators developed by Faraco et al. were used to define the capacity of Pharmaceutical Services management. Pearson’s chi-square test and multivariate analysis were performed to associate Pharmaceutical Services management capacity with socioeconomic indices of each municipality. These socioeconomic indices were collected from public database platforms.Results The results prove significant relationships between management and socioeconomic indicators, suggesting that Pharmaceutical Services management capacity is influenced by the environment in which it operates. This study shows municipalities with better management capacity results were those with better socioeconomic indices, better health system conditions and structure, reflecting a greater number of professionals, greater participation of popular social control and use public resources. It is also highlighted that municipalities with a smaller population size and lower socio-economic indices have less ability to manage pharmaceutical services, revealing worsening inequalities for its citizens.Conclusions The existence of an adequate minimum structure, a qualified workforce, service organization, and opportunities for political articulation are essential, as well as conditions for these municipalities to develop and improve their management capacity and for financing based on socioeconomic indicators to become an effective access and adequate use of medicines for the population.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Pharmaceutical Services Management Capacity and the Municipal Socioeconomic Scenario: Persistent Inequalities

Faraco

Rover

Cunha

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…4 This result can be attributed to these individuals' knowledge of disease prevention, health promotion measures and care and control present greater inequalities in healthcare and more discrepant socioeconomic indicators, which are considered to be a proxy for multimorbidity. 3 The counterpoint described for the older adult population can be explained by the higher proportion of financial resources that are allocated to primary healthcare in the southeastern and central-western regions of Brazil, 30 which enables better prevention and control measures regarding health outcomes, including NCDs.…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study

et al. 2022

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INTRODUCTIONMultimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenges for healthcare systems. 1 It is reflected in increased health problems, financial expenditure and decreased quality of life. 2 Over 95% of the population over 65 years of age is estimated to present more than one disease diagnosed in primary healthcare. 3 Middle-income countries such as China, 4 Serbia, Mexico, Russia, South Africa and India 5 present alarming multimorbidity results, but knowledge about simultaneous diseases in Latin American countries is limited. Specifically in Brazil, 6 studies have emphasized occurrences in subgroups of the population comprising older adults. [7][8][9] Investigation of the determinants of multimorbidity, especially the sociodemographic aspects, is crucial for planning preventive public policies. 10 Some important variables need to be included in these investigations, in order to identify the population segment that is more exposed to NCD multimorbidity. These variables may include sex, age, marital status, skin color and educational level. The locality is also important. It can also be considered that population density, seasonal patterns, urbanization, economy 11 and cultural contextualization may influence inequalities and health disparities.Separately, each NCD has important sociodemographic determinants, which reflect health inequalities and the populations most affected. In the case of multimorbidity, identifying the inherent indicators of the population is of considerable importance, in order to reflect on phenomena of disability and mortality, which are strongly related to diagnoses of multiple chronic diseases. 2 Therefore, recognition of sociodemographic determinants enables knowledge of the population subgroups that are most vulnerable to the aggravation of presenting interactions of multiple diseases.

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“…In Brazil, around 23% of the municipalities are medium (25 to 100 thousand inhabitants) and large (more than 100 thousand inhabitants) [ 37 ]. Municipalities with a larger population have more complex health systems and greater difficulty in structuring PHC and consolidating a preventive health care model [ 38 ]. In larger municipalities, it is also observed that the availability of health services may not be known to everyone, and the degree of information about the services available varies between different population groups [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Failure to use health services by people with Chagas disease: Multilevel analysis of endemic area in Brazil

et al. 2022

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This study aimed to assess the prevalence of non-use of health services in the last year by people with Chagas disease (CD) in an endemic area in Brazil and the contextual and individual factors associated with this non-use. This is a multilevel study that considered contextual and individual data. Contextual data were collected from official publicly accessible databases of the Brazilian government, at the municipal level. The individual data came from the first follow-up of a Brazilian cohort that assessed patients with CD in 21 municipalities in endemic area for the disease. The sample consisted of 1,160 individuals with CD. The dependent variable “use of health services in the last year” was categorized as yes vs. no. The analysis was performed using Poisson regression with robust variance. The prevalence of non-use of health services in the last year was 23.5% (IC95%: 21.1–25.9). The contextual factor “larger population” (PR: 1.6; 95% CI = 1.2–2.0) and individual factors related to the lower severity of the disease as a functional class without limitations (PR: 1.6; 95% CI = 1.2–2.1) and unaltered N-terminal pro b-type natriuretic peptide levels (PR: 2.2; 95% CI = 1.3–3.6) increased the prevalence of non-use of the health service in the last year by people with CD. The results of this study showed that individual determinants are not isolated protagonists of the non-use of health services in the last year by people with CD, which reinforces the need for public policies that consider the contextual determinants of the use of health services by populations affected by the disease.

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Atenção Primária à Saúde nos municípios brasileiros: eficiência e disparidades

Cited by 7 publications

References 6 publications

Pharmaceutical Services Management Capacity and the Municipal Socioeconomic Scenario: Persistent Inequalities

Pharmaceutical Services Management Capacity and the Municipal Socioeconomic Scenario: Persistent Inequalities

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study

Failure to use health services by people with Chagas disease: Multilevel analysis of endemic area in Brazil

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