The physiotherapy workforce in the Brazilian Unified Health Care System (original) (raw)
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Fisioterapia em Movimento
Introduction Public health in Brazil goes beyond social production, with an expanded view of health. Its complex structure includes physical therapy. Objective To characterize physical therapy in Goiás based on the National Registry of Health Facilities (CNES in Portuguese). Methods Data on specialty, municipality, place of employment, working hours, employment relationship, type of contract and establishment, number of physical therapists, administrative setting, macroregion and health region were tabulated. The following were correlated: municipal population; people dependent on the National Health System (SUS in Portuguese); municipal per capita gross domestic product (GDP); municipal Human Development Index (HDI); percentage of inhabitants dependent on the municipal SUS; number of people covered by municipal physiotherapy (NPCAF). Results In the CNES, (reference July/2019) in Goiás, we found 2,187 physiotherapists in public/private facilities, in 3,353 workplaces. In establishme...
Needs and dynamics of the Primary Healthcare workforce in Brazil
Ciencia & saude coletiva, 2018
Primary care and the healthcare workforce can be considered the greatest challenges of SUS (Sistema Único de Saúde), principally in recent decades. This article aims to describe the growth and regional distribution of the professions requiring higher education registered in the primary healthcare units. This descriptive study with a quantitative approach is concerned with the 14 accredited professions in the five major regions of Brazil from 2008 to 2013. The data was collected from the national database of the Ministry of Health. Among the professional categories with the greatest rates of national growth are physical education teachers, nutritionists, occupational therapists, physiotherapists, and pharmacists. In the North region of Brazil, physiotherapy, social work, and speech therapy stand out as having the greatest growth rates; in the Northeast, physical education, physiotherapy, and occupational therapy; and in the Center-West, nutrition and physiotherapy; in the Southeast, ...
Ciência & Saúde Coletiva
The complex epidemiological profile of Brazil, the aging population and the proportion of individuals with disabilities have led to a substantial increase in the demand for rehabilitation. The spatiotemporal distribution of the offer of physiotherapy, speech therapy and occupational therapy in the Brazilian public healthcare system from 2007 to 2019 was analyzed for the five macro-regions of the country. Data from the National Register of Health Establishments and census estimates from the Brazilian Institute of Geography and Statistics were used. Indicators of the offer of professionals in these fields services and relative changes in the offer were calculated. The spatial distribution of the relative change in the offer was also determined. A regression model with inflection points was adopted for the analysis of the temporal trend. A growing temporal trend was found in the offer of the three professionals in Brazil as a whole and in all regions of the country, but with a slowdown...
Analysis of the distribution of the health workforce in Brazil
Research, Society and Development
In Brazil, primary health care counts with multidisciplinary teams, comprising doctors, nurses, dentists, nutritionists, psychologists, pharmacists, physiotherapists, social workers and veterinarians, working in a complementary way. The objective of this study was to analyze the increase of these nine health professions from the censuses of the Brazilian Institute of Geography and Statistics (IBGE) for 2000 and 2010, identifying the panorama of the Work Force in health in all health regions in Brazil. There was an increase in the numbers of all professions in the period, especially induced by public policies. However, there are still problems, especially with doctors and dentists, due to uncovered areas such as remote and rural regions with difficult access. We underscore the importance of conducting health education, training and allocation of professionals, based on the needs of the health sector in Brazil for the provision of the labor force in areas with some degree of vulnerabi...
This study analyzes the number of medical appointments and referrals performed in primary health care in Brazil focusing on the Mais Médicos Program (More Doctors Program). It is a cross-sectional study on the work of physicians included, or not, to the Mais Médicos Program in 2014. Based on validation protocols, a unified database was created from two health information system databases – SIAB and ESUS. Absolute indicators were defined: the total of medical appointments per month; medical referrals and community health education activities. In addition , other indicators were considered, such as weekly rates and productivity of appointments, in line with the profile of Brazilian municipalities. The mean of all appointments was 285 per month corresponding to an average of 14.4 ap-pointments/day. In the poorest municipalities, the figures for the Mais Médicos Program physicians were higher than national rates. The educational activities provided by primary care teams that included a Mais Médicos Program professional were higher in Brazilian capital cities. The Mais Médicos Program achieved one of its main goals, which was to increase health access for vulnerable populations and to contribute towards the consolidation of primary health care in Brazil.
The inadequate placement and distribution of health professionals are problems that occur in various countries. The scope of the " Pro-grama Mais Médicos " (More Doctors Program) was to reduce the shortfall of physicians and diminish regional inequalities in health. A descriptive study on the placement of physicians between 2013 and 2014 using the Ministry of Health database is presented. There was an allocation of 14,168 physicians to the 3,785 municipalities that signed up to the program: 2,377 met the priority and/or vulnerability criteria and received 77.7% of the physicians; 1,408 received 22.3% of the physicians , but did not meet the established priorities. This study reveals the reduction in the lack of physicians , mainly in the North and Northeast. These regions account for 36% of the Brazilian population and 46.3% of the physicians were allocated there. However, the introduction of an eligibility profile, which allocated 3,166 physicians in 1,408 non-priority municipalities is questionable. The conclusion drawn is that this may have hindered the ability of the Mais Médicos Program to fully achieve its objectives as a public policy aimed at reducing regional inequalities of access to primary healthcare. Further studies are necessary to evaluate the impact of the Mais Médicos Program.
2019
1 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited. No modifications or commercial use of this article are permitted. In any reproduction of this article there should not be any suggestion that PAHO or this article endorse any specific organization or products. The use of the PAHO logo is not permitted. This notice should be preserved along with the article’s original URL. Primary health care performance in Brazil and its correlation with the Mais Médicos physician recruitment program*
Physiotherapy practices in primary health care
Fisioterapia em Movimento, 2021
Introduction: Physiotherapy was included in primary health care (PHC) in order to expand access and provide comprehensive care to the population. Objective: To understand the routine and tools used by physiotherapists in primary health care and analyze the determining factors in providing care in a municipality where every basic health unit (BHU) has a physiotherapist. Methods: This is a qualitative study of nineteen physiotherapists conducted in a city of Southern Brazil, using a semistructured interview and a methodological framework for discourse analysis. Results: The main tools routinely used in the physiotherapy service are individual appointments, home visits and group work. Physiotherapy practices are influenced by public health, municipal management and BHU policies, physiotherapy profile in addition to the characteristics of the coverage area and the population being treated. Introducing health promotion measures and implementing relational technologies are the main challe...
Brazilian Health Care Sector Overview
The Brazilian Health Care sector is one of the largest and fastest growing markets in the world. According to industry analysts, Brazil spends and invests approximately 9 % of its GDP annually on health care. The country has 7,000 hospitals, 70% of which are privately owned. Medical equipment and pharmaceutical imports continue to grow at more than 10% a year. Companies are also expanding into sectors such as primary care assistance, prevention, home care and treatment of rare and chronic diseases. At the same time, the Brazilian Government has been promoting its public private partnership model as a means to increase access, reduce imports and develop its own healthcare industry.