Evolução da cobertura de médicos em estratégia saúde da família na atenção primária do SUS nos municípios de Minas Gerais: uma avaliação sob a ótica da equidade no contexto do Programa Mais Médicos

• Ano de defesa: 2018
• Autor(a) principal: Morais, João Roberto Muzzi
• Orientador(a): Ferreira Júnior, Silvio
• Banca de defesa: Fahel, Murilo Cássio Xavier, Pereira, Danielle Ramos de Miranda
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Fundação João Pinheiro
• Programa de Pós-Graduação: Programa de Mestrado em Administração Pública
• Departamento: Escola de Governo Professor Paulo Neves de Carvalho
• País: Brasil
• Palavras-chave em Português: Política de saúde; Saúde da família; Médico
• Área do conhecimento CNPq: ADMINISTRACAO PUBLICA::POLITICA E PLANEJAMENTO GOVERNAMENTAIS
• Link de acesso: http://repositorio.fjp.mg.gov.br/handle/tede/389

The trajectory of public health policies demonstrates a continuous effort in opposition to health inequities, including new mechanisms that favor the attraction and fixation of medical professionals. Therefore, this dissertation had as main objective to analyze the evolution of the coverage of medical professionals in FHS, in the scope of the PHS of the SUS and of the implementation of the Program More Doctors. For this, we used descriptive and inferential statistics, as well as cartographic analysis, in an attempt to identify if there was a positive evolution of this coverage and to what extent economic, social, population and structural factors contributed to a greater or lesser increase in the quantitative of these professionals in the State of Minas Gerais. The descriptive analysis indicated an increase in the growth rate of physicians in ESF of 7.53 doctors / 100 thousand inhabitants, as well as in the median values, in absolute terms, comparing the years of 2012 and 2016, in addition to a positive evolution of the median, considering the expanded health regions. There was also a decrease in the coefficient of variation, considering the coverage of physicians in FHS. It is also worth mentioning the significant decrease in the number of municipalities with a FHP / inhabitants ratio equal to zero. From the health needs index, it was verified that the evolution of the growth rate of the enlarged health regions was more frequent in those that presented greater need. The descriptive analysis of the quality index of the BHUs suggested less heterogeneity, when compared to the INS analysis. The cartographic analysis suggested a relation, although not in its totality, between the quality of the BHUs and greater health needs. Regarding the regression analysis by population size, the results were significant for the less populous municipalities, with up to 10 thousand inhabitants. As for the regressions by extended health regions, the results reinforce the need to evaluate public policies at a more specific level. However, locations with lower rates of FHP / resident physicians appear to have been prioritized and had a more robust increase in FHP physicians' rates. Finally, the allocation of physicians, in the context of the PMM, seems to have been effective and equitable, since there was a positive evolution of the growth rate of physicians in FHT, being this evolution more robust in municipalities eligible to PMM. In addition, the study suggests a decrease in inter-municipal intra- and inter-regional inequalities of medical professionals in FHS, within the scope of PHC in MG.