Girardi Sábado Nicolau, Stralen Ana Cristina de Sousa van, Cella Joana Natalia, Wan Der Maas Lucas, Carvalho Cristiana Leite, Faria Erick de Oliveira
Observatório de Recursos Humanos em Saúde, Estação de Pesquisa de Sinais de Mercado, Núcleo de Estudos em Saúde Coletiva, Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190/7° andar, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
Cien Saude Colet. 2016 Sep;21(9):2675-84. doi: 10.1590/1413-81232015219.16032016.
The Mais Médicos (More Doctors) Program (PMM) was put in place in Brazil aiming to reduce inequalities in access to Primary Healthcare. Based on diverse evidence that pointed to a scenario of profound shortage of doctors in the country, one of its central thrusts was emergency provision of these professionals in vulnerable areas, referred to as the Mais Médicos para o Brasil (More Doctors for Brazil) Project. The article analyses the impact of the PMM in reducing shortage of physicians in Brazilian municipalities. To do this, it uses the Primary Healthcare Physicians Shortage Index, which identifies and measures the shortage in the periods of March 2003 and September 2015, before and after implementation of the program. The results show that there was a substantial increase in the supply of physicians in primary healthcare in the period, which helped reduce the number of municipalities with shortage from 1,200 to 777. This impact also helped reduce inequalities between municipalities, but the inequities in distribution persisted. It was also found that there was a reduction in the regular supply of doctors made by municipalities, suggesting that these were being simply substituted by the supply coming from the program. Thus, an overall situation of insecurity in care persists, reflecting the dependence of municipalities on the physician supply from the federal government.
“更多医生”计划（PMM）在巴西实施，旨在减少初级医疗保健获取方面的不平等。基于各种证据表明该国医生严重短缺的情况，其核心举措之一是在脆弱地区紧急提供这些专业人员，即“为巴西提供更多医生”项目。本文分析了“更多医生”计划对减少巴西各市医生短缺的影响。为此，它使用了初级医疗保健医生短缺指数，该指数确定并衡量了2003年3月和2015年9月该计划实施前后的短缺情况。结果表明，在此期间初级医疗保健中医生的供应大幅增加，这有助于将短缺的市数量从1200个减少到777个。这一影响也有助于减少各市之间的不平等，但分配方面的不公平现象仍然存在。还发现各市医生的常规供应有所减少，这表明这些供应只是被该计划的供应所取代。因此，医疗保健方面的整体不安全状况依然存在，这反映了各市对联邦政府医生供应的依赖。
