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不缺医生,但不均衡:巴西神经科医生的人口演变(2010-2020 年)。

There is no shortage, but inequality: demographic evolution of neurologists in Brazil (2010-2020).

机构信息

Universidade Federal do Pará, Laboratório de Neuropatologia Experimental, Belém PA, Brazil.

Hospital Ophir Loyola, Belém PA, Brazil.

出版信息

Arq Neuropsiquiatr. 2023 Feb;81(2):134-145. doi: 10.1055/s-0043-1761490. Epub 2023 Mar 22.

Abstract

BACKGROUND

Neurology is a medical specialty that deals with prevalent diseases such as stroke, headache, epilepsy, and neurodegenerative diseases. Many countries, such as Brazil, struggle to provide neurological care for their populations, but the inadequacy and unequal distribution of the neurologist workforce are real challenges.

OBJECTIVE

To analyze the demographic evolution of neurologists and the first-year Neurology residency positions in Brazil during the last decade (2010-2020) and the distribution imbalance between regions.

METHODS

The demographic and geographic distribution of neurologists was calculated based on data extracted from the Brazilian Federal Medical Council reports, and the number of Neurology residency positions was based on the Brazilian National Commission of Medical Residency reports. Indicators of wealth were associated with demographic data.

RESULTS

The number of neurologists per 100,000 population has increased since 2011, with a similar increase in the geographic distribution of neurologists. However, there was a marked inequality of distribution of neurologists through regions, with a gap between the Northern (lowest) and Southeastern (highest) regions. Furthermore, the imbalance of distribution of neurologists strongly correlated with social inequality. The number of Neurology residency positions increased, but with an imbalance between North and Southeast regions.

CONCLUSIONS

Brazil has advanced in providing neurologists. However, instead of a shortage, inequality between regions is the greatest challenge regarding the neurological workforce. The training of new neurologists is unequal between regions and occurs at a slower rate than needed. Neurologists, public health authorities, and patients should discuss solutions for these issues.

摘要

背景

神经病学是一门医学专业,主要研究中风、头痛、癫痫和神经退行性疾病等常见疾病。许多国家,如巴西,都在努力为其民众提供神经科护理,但神经科医生劳动力的不足和分布不均是现实挑战。

目的

分析过去十年(2010-2020 年)巴西神经病学家的人口统计学演变和第一年神经病学住院医师职位,以及地区之间分布不平衡的情况。

方法

根据从巴西联邦医学委员会报告中提取的数据,计算了神经病学家的人口统计学和地理分布情况,根据巴西国家医学住院医师委员会的报告,计算了神经病学住院医师职位的数量。财富指标与人口统计学数据相关联。

结果

自 2011 年以来,每 10 万人中神经病学家的数量有所增加,神经病学家的地理分布也有类似的增加。然而,神经病学家的分布存在明显的区域不平等,北部(最低)和东南部(最高)地区之间存在差距。此外,神经病学家分布的不平衡与社会不平等密切相关。神经病学住院医师职位的数量有所增加,但北部和东南部地区之间存在不平衡。

结论

巴西在提供神经病学家方面取得了进展。然而,与短缺相比,区域不平等是神经科劳动力面临的最大挑战。新神经病学家的培训在地区之间存在不平衡,而且速度比需要的慢。神经病学家、公共卫生当局和患者应该讨论解决这些问题的办法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62a6/10033185/1cd25ff68c7d/10-1055-s-0043-1761490-i220103-1.jpg

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