Rocha Rudi
São Paulo School of Business Administration, Getulio Vargas Foundation, Brazil.
Soc Sci Med. 2025 Jan;364:117559. doi: 10.1016/j.socscimed.2024.117559. Epub 2024 Nov 23.
In their paper "More Doctors, better health? A generalised synthetic control approach to estimating impacts of increasing doctors under Brazil's Mais Medicos Programme", Thomas, Millett, Soares and Hone add novel empirical evidence on the effects of Brazil's Programa Mais Medicos (PMM) on population health outcomes, reinforcing evidence that PMM has had limited effects: while PMM improved healthcare access in underserved regions, results show little impact on more extreme outcomes, such as mortality. Here I collect and connect evidence from the Brazilian context to discuss three potential explanations that, inter alia, could help us better understand why evidence from Thomas et al. (2024) as well as from previous research efforts points to a weak relationship between physician supply and population health. The potential explanations include health production complexity, system adaptability, and the increasing challenge of managing chronic diseases, emphasizing the need for more integrated healthcare approaches.
在他们的论文《更多医生，更健康？一种广义合成控制方法，用于评估巴西“更多医生计划”增加医生数量的影响》中，托马斯、米利特、苏亚雷斯和霍恩补充了关于巴西“更多医生计划”（PMM）对人口健康结果影响的新实证证据，强化了PMM效果有限的证据：虽然PMM改善了服务不足地区的医疗服务可及性，但结果显示对诸如死亡率等更极端的结果影响甚微。在此，我收集并梳理来自巴西背景的证据，以讨论三个潜在的解释，这些解释尤其有助于我们更好地理解为什么托马斯等人（2024年）以及先前研究的证据都表明医生供应与人口健康之间的关系较弱。这些潜在解释包括健康生产的复杂性、系统适应性以及管理慢性病日益增加的挑战，强调了采用更综合医疗方法的必要性。
