Avaliação de impacto do Programa Mais Médicos do Brasil: a chegada dos profissionais nos municípios e o seu reflexo na atenção básica à saúde.

Abstract

It is the State's duty to promote public health policies, and among those aimed at improving Primary Care is the Mais Médicos Program (PMM), which aims, in the emergency provision axis, to take doctors to locations where there were a reduced number of professionals or even its nonexistence. However, it is necessary to analyze the impact of this Program on health indicators, seeking to know if it was able to bring about improvements or not. In this sense, the following research problem arises: What is the impact of the PMM on the health of the Brazilian population, considering the increase in the number of physicians in the municipalities participating in the PMM arising from the emergency provision? As an initial hypothesis, we suggest that the program improved the population's health conditions by increasing the number of physicians in primary care. The design of the selected public policy was analyzed to understand its working logic and its beneficiaries, with data collection to test the suggested hypothesis. Such data were collected from the Ministry of Health, Department of Informatics of the Unified Health System (DATASUS) and the Brazilian Institute of Geography and Statistics (IBGE), and were treated and used in a descriptive and inferential manner. The PMM was analyzed in Brazilian municipalities, at different geographic levels (Regions and division of municipalities into Legal Amazon, Border Zone, Semi- Arid and Extreme Poverty), checking the before and after of the selected variables. To test the initial hypothesis, variables such as number of physicians per municipality, number of admissions for conditions sensitive to primary care, number of notified tuberculosis cases, among others, were selected. It was found that there was a statistically significant increase in the number of physicians in the municipalities, there was also a reduction in hospitalizations for sensitive conditions to primary care across the country, but with statistical significance only in municipalities in extreme poverty and in the semiarid region. As for notified tuberculosis cases, a negative association with the program was perceived in the Northeast, in the municipalities of Extreme Poverty and in those that are part of the Semiarid region, and in relation to leprosy cases there is a negative causal relationship between them and the program in the Southern region of the country. In this sense, it is observed that although the PMM has impacted on the increase in the number of physicians in Brazilian Municipalities, there is still a need for greater supervision by managers in its execution to ensure better results and spread the positive results of some regions throughout the parents.