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More doctors, better health?

2024-10Artigo científico Desconhecido
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dc.contributor.authorThomas, Rhys Llewellyn
dc.contributor.authorMillett, Christopher
dc.contributor.authorSousa Soares, Ricardo de
dc.contributor.authorHone, Thomas
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.pblElsevier
dc.date.accessioned2024-09-27T22:26:08Z
dc.date.available2024-09-27T22:26:08Z
dc.date.issued2024-10
dc.descriptionFunding Information: Some of this work was done while Rhys Llewellyn Thomas was a PhD Student at the University of Southampton, which was funded by an ESRC 1+3 PhD Studentship. Funding Information: This project was funded by Medical Research Council ( MRC )/Newton Fund UK- CONFAP Joint Initiative on Health Systems Research grant MR/R022887/1, Funda\u00E7\u00E3o de Apoio \u00E0 Pesquisa do Distrito Federal (FAP/ DF ) grant number 00193\u201300000356/2018\u201324 and Funda\u00E7\u00E3o de Apoio \u00E0 Pesquisa da Para\u00EDba ( FAPESQ / PB) grant number 001/2018. Publisher Copyright: © 2024 The Authors
dc.description.abstractWorldwide, there are an insufficient number of primary care physicians to provide accessible, high-quality primary care services. Better knowledge on the health impacts of policies aimed at improving access to primary care physicians is important for informing future policies. Using a generalised synthetic control estimator (GSC), we estimate the effect of the increase in primary care physicians from the Programa Mais Médicos in Brazil. The GSC allows us to estimates a continuous treatment effects which are heterogenous by region. We exploit the variation in physicians allocated to each Brazilian microregion to identify the impact of an increasing Mais Médicos primary care physicians. We explore hospitalisations and mortality rates (both total and from ambulatory care sensitive conditions) as outcomes. Our analysis differs from previous work by estimating the impact of the increase in physician numbers, as opposed to the overall impact of programme participation. We examine the impact on hospitalisations and mortality rates and employ a panel dataset with monthly observations of all Brazilian microregion over the period 2008–2017. We find limited effects of an increase in primary care physicians impacting health outcomes - with no significant impact of the Programa Mais Médicos on hospitalisations or mortality rates. Potential explanations include substitution of other health professionals, impacts materialising over the longer-term, and poor within-region allocation of Mais Médicos physicians.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent9662945
dc.identifier.doi10.1016/j.socscimed.2024.117222
dc.identifier.issn0277-9536
dc.identifier.otherPURE: 100132118
dc.identifier.otherPURE UUID: 503ea263-9e1d-4c9a-b5c3-641adfa378e2
dc.identifier.otherScopus: 85201781437
dc.identifier.otherPubMed: 39181082
dc.identifier.otherWOS: 001301794700001
dc.identifier.urihttp://hdl.handle.net/10362/172587
dc.identifier.urlhttps://www.scopus.com/pages/publications/85201781437
dc.language.isoeng
dc.peerreviewedyes
dc.subjectBrazil
dc.subjectDoctors
dc.subjectHospitalisations
dc.subjectHuman resources for health
dc.subjectMortality
dc.subjectPrimary care
dc.subjectSynthetic control
dc.subjectHealth(social science)
dc.subjectHistory and Philosophy of Science
dc.subjectSDG 3 - Good Health and Well-being
dc.titleMore doctors, better health?en
dc.title.subtitlea generalised synthetic control approach to estimating impacts of increasing doctors under Brazil's Mais Medicos programmeen
dc.typejournal article
degois.publication.titleSocial Science and Medicine
degois.publication.volume358
dspace.entity.typePublication
rcaap.rightsopenAccess

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