2008年至2019年间巴西初级卫生保健的结构演变与成果

Evolution of the structure and results of Primary Health Care in Brazil between 2008 and 2019.

作者信息

Barros Rafael Damasceno de, Aquino Rosana, Souza Luis Eugênio Portela Fernandes

机构信息

Escola de Enfermagem, Universidade Federal da Bahia (UFBA). R. Basílio da Gama s/n, Canela. 40110-907 Salvador BA Brasil.

Instituto de Saúde Coletiva, UFBA. Salvador BA Brasil.

出版信息

Cien Saude Colet. 2022 Nov;27(11):4289-4301. doi: 10.1590/1413-812320222711.02272022. Epub 2022 Jul 2.

Abstract

This paper describes the structure and results of Primary Health Care (PHC) in Brazil between 2008 and 2019. The medians of the following variables were calculated: PHC spending per inhabitant covered, PHC coverage, and rates of mortality and hospitalizations due to primary care sensitive conditions (PCSC), in 5,565 Brazilian municipalities stratified according to population size and quintile of the Brazilian Deprivation Index (IBP), and the median trend in the period was analyzed. There was a 12% increase in median PHC spending. PHC coverage expanded, with 3,168 municipalities presenting 100% coverage in 2019, compared to 2,632 in 2008. The median rates of PCSC mortality and hospitalizations increased 0.2% and decreased 44.9%, respectively. PHC spending was lower in municipalities with greater socioeconomic deprivation. The bigger the population and the better the socioeconomic conditions were in the municipalities, the lower the PHC coverage. The greater the socioeconomic deprivation was in the municipalities, the higher the median PCSC mortality rates. This study showed that the evolution of PHC was heterogeneous and is associated both with the population size and with the socioeconomic conditions of the municipalities.

摘要

本文描述了2008年至2019年巴西初级卫生保健(PHC)的结构和成果。计算了以下变量的中位数:按人口规模和巴西贫困指数(IBP)五分位数分层的5565个巴西城市中,人均覆盖初级卫生保健支出、初级卫生保健覆盖率以及因初级保健敏感疾病(PCSC)导致的死亡率和住院率,并分析了该时期的中位数趋势。初级卫生保健支出中位数增长了12%。初级卫生保健覆盖率有所扩大,2019年有3168个城市实现了100%覆盖,而2008年为2632个。PCSC死亡率和住院率的中位数分别上升了0.2%和下降了44.9%。社会经济剥夺程度较高的城市,初级卫生保健支出较低。城市人口越多、社会经济条件越好,初级卫生保健覆盖率越低。城市社会经济剥夺程度越高,PCSC死亡率中位数越高。本研究表明,初级卫生保健的发展是不均衡的,并且与城市人口规模和社会经济条件都有关联。

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