巴拉那州北部宏观区域内小城市对“巴西更多医生”计划的参与情况。

Participation of small municipalities in the Mais Médicos para o Brasil (More Doctors to Brazil) Program in the macro-region of Northern Paraná.

作者信息

Mendonça Fernanda de Freitas, Mattos Luis Fernando Abucarub de, Oliveira Emmeline Bernardes Duarte de, Domingos Carolina Milena, Okamura Carlos Takeo, Carvalho Brígida Gimenez, Nunes Elisabete de Fátima Polo de Almeida

机构信息

Departamento de Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual de Londrina. Av. Robert Koch 60, Vila Operária. 86039-440 Londrina PR Brasil.

出版信息

Cien Saude Colet. 2016 Sep;21(9):2907-15. doi: 10.1590/1413-81232015219.18302016.

Abstract

Doctor shortage is a constant problem in smaller cities and towns, which tend to be more vulnerable from a social and economic point of view, and located in geographically isolated areas. The goal of this study was to establish the share and characteristics of the small cities and towns in the macro-region of northern Paraná that subscribed to the Mais Médicos para o Brasil (PMMB) program. This is a quantitative study of 82 cities and towns using primary and secondary data. Results show that only a few of them (6.1%) had any adherence criteria, which was not an impediment for other cities and towns (75%) to adhere to the project. Cities and towns with over five thousand inhabitants, lower municipal HDI (Human Development Index), some adherence criteria and more geographically isolated, either from the main city in the region or the closest large or mid-sized city, tended to adhere to the PMMB. It is undeniable that the PMMB significantly reduced the uneven distribution of doctors in Brazil and the study region. However, the sustainability of this policy is linked to addressing other remaining challenges in the SUS system.

摘要

医生短缺在较小的城镇一直是个问题,这些城镇从社会和经济角度来看往往更为脆弱,且位于地理上孤立的地区。本研究的目的是确定巴拉那州北部宏观区域内订阅了“巴西更多医生”(PMMB)计划的小城镇的占比及特征。这是一项利用一手和二手数据对82个城镇进行的定量研究。结果显示,其中只有少数城镇(6.1%)符合任何参与标准,而这并非其他城镇(75%)参与该项目的障碍。居民超过五千、市政人类发展指数(HDI)较低、有一些参与标准且在地理上与该地区主要城市或最近的大、中型城市更为隔绝的城镇,往往会参与PMMB。不可否认,PMMB显著减少了巴西及研究区域内医生分布不均的情况。然而,这项政策的可持续性与应对统一卫生系统(SUS)中其他尚存的挑战相关联。

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