Thomas, Rhys LlewellynMillett, ChristopherSousa Soares, Ricardo deHone, Thomas2024-09-272024-09-272024-100277-9536PURE: 100132118PURE UUID: 503ea263-9e1d-4c9a-b5c3-641adfa378e2Scopus: 85201781437PubMed: 39181082WOS: 001301794700001http://hdl.handle.net/10362/172587Funding 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 AuthorsWorldwide, 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.9662945engBrazilDoctorsHospitalisationsHuman resources for healthMortalityPrimary careSynthetic controlHealth(social science)History and Philosophy of ScienceSDG 3 - Good Health and Well-beingjournal article10.1016/j.socscimed.2024.117222https://www.scopus.com/pages/publications/85201781437