Assessing the impact of a doctor in remote areas of Brazil

dos Santos, Joana Raquel Raposo; dos Santos, Hellen Geremias; Dias, Carlos Manuel Matias; Filho, Alexandre Dias Porto Chiavegatto

http://hdl.handle.net/10400.18/7647

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Authors

dos Santos, Joana Raquel Raposo

dos Santos, Hellen Geremias

Dias, Carlos Manuel Matias

Filho, Alexandre Dias Porto Chiavegatto

Abstract(s)

Objectives: The More Doctors Program (MDP) is an ongoing Brazilian policy that aims to improve healthcare by providing physicians to the most vulnerable municipalities. We aimed to measure the impact of MDP in mortality and infant mortality rate, the proportion of live births with low weight, prenatal appointments, childbirths at first and fifth min Apgar, public health investment and immunization in Brazil. Methods: Municipal health indicators were collected before and after the intervention (2012 and 2015). Effects were measured by applying propensity score matching with difference-in-differences. Results: Our findings show that infant mortality presented the highest improvement during the period (a decrease in 11 infant deaths per 1000 live births, p < 0.01). A significant effect, albeit smaller, was also found for the age-standardized total mortality (a decrease in five deaths per 10,000 residents), proportion of children with Apgar score lower than 8 in the fifth min and children with low birth weight. Conclusions: MDP contributed to improve important health indicators, highlighting the importance of a doctor in remote areas of Brazil.

Keywords

Adolescent Adult Aged Aged, 80 and over Brazil Child Child, Preschool Cities Delivery of Health Care Female Humans Infant Infant, Newborn Male Middle Aged Mortality Physicians Pregnancy Propensity Score Public Health Quality Indicators, Health Care Rural Health Services Vulnerable Populations Young Adult Infant Mortality Propensity Score; Public Policy Cuidados de Saúde