Effect of the More Doctors Program on primary care sensitive conditions in Brazil

Russo et al.

The present article aimed at evaluating the effect of the More Doctors Program (PMM) on primary care sensitive conditions (PCSC) by age group in Brazil. A longitudinal study was performed using a dynamic panel data approach. Municipalities were considered as the unit of analysis; the 5 570 Brazilian municipalities existing in Brazil from 2008 to 2016 were analyzed. The effect of the PMM was evaluated according to the exposure of municipalities to the program. For that, the municipalities in which at least 50% of primary care physicians were linked to the PMM were identified. Robustness tests with alternative exposures to the program (30%, 40%, 60% and 70%) were performed. A set of vulnerability variables was included for control: number or primary care physicians, number of Family Health Strategy nurses/nursing technicians or assistants per 10 000 population; number of hospital beds per 10 000 population; municipal education development and income/employment indices; percentage of population with health insurance plans; and percentage of households with sewer lines. A consistent effect of the PMM on PCSC reduction was detected. This result was observed for all age groups, with greater impact on the 0 to 4 year-old group, in which a 3.7% reduction in PCSC rates was recorded. In adults (20 to 64 years), a 3.1% reduction was recorded. The results show that the higher the exposure to the PMM, the stronger the effect on PCSC reduction. Also, the municipalities with higher exposure to the PMM were the most vulnerable. In conclusion, the PMM contributed to improve the health of the population, especially in high vulnerability areas.

Article's language
Portuguese
Original research