Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance

Detalhes bibliográficos
Autor(a) principal: Hone, Thomas
Data de Publicação: 2017
Outros Autores: Rasella, Davide, Barreto, Maurício Lima, Atun, Rifat, Majeed, Azeem, Millett, Christopher
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/18988
Resumo: Imperial College de Londres, como Programa de doutorado de Thomas Hone, e parcialmente através da Da Saúde e do Ministério da Saúde do Brasil, como parte de uma Programa de pesquisa colaborativa sobre o sistema de saúde brasileiro. Sugerir uma edição Google Tradutor para empresas:Google Toolkit de tradução para appsTradutor de sitesGlobal Market Finder Sobre o Google TradutorComunidadeCelular Sobre o GooglePrivacidade e TermosAjudaEnviar feedback Imperial College London, as part of Thomas Hone’s PhD program, and partially through the Pan American Health Organization and the Brazilian Ministry of Health.
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spelling Hone, ThomasRasella, DavideBarreto, Maurício LimaAtun, RifatMajeed, AzeemMillett, Christopher2017-05-22T13:37:44Z2017-05-22T13:37:44Z2017HONE, T. et al. Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance. Health Affairs, v. 36, n.1, p. 149-158, 2017.1544-5208https://www.arca.fiocruz.br/handle/icict/1898810.1377/hlthaff.2016.0966Imperial College de Londres, como Programa de doutorado de Thomas Hone, e parcialmente através da Da Saúde e do Ministério da Saúde do Brasil, como parte de uma Programa de pesquisa colaborativa sobre o sistema de saúde brasileiro. Sugerir uma edição Google Tradutor para empresas:Google Toolkit de tradução para appsTradutor de sitesGlobal Market Finder Sobre o Google TradutorComunidadeCelular Sobre o GooglePrivacidade e TermosAjudaEnviar feedback Imperial College London, as part of Thomas Hone’s PhD program, and partially through the Pan American Health Organization and the Brazilian Ministry of Health.School of Public Health. Imperial College London. Public Health Policy Evaluation Unit. Department of Primary Care and Public Health. London, England / Harvard T. H. Chan School of Public Health. Boston, MassachusettsFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, BrasilHarvard University. Cambridge, Massachusetts, EUAImperial College London. Department of Primary Care and Public Health. London, EnglandImperial College London. Center for Epidemiological Studies in Health and Nutrition. Department of Primary Care and Public Health. London, England / Universidade de São Paulo. Institute of Social Medicine. Department of Epidemiology. São Paulo, SP, Brasil / Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, BrasilStrong health governance is key to universal health coverage. However, the relationship between governance and health system performance is underexplored. We investigated whether expansion of the Brazilian Estratégia de Saúde da Família (ESF; family health strategy), a community-based primary care program, reduced amenable mortality (mortality avoidable with timely and effective health care) and whether this association varied by municipal health governance. Fixed-effects longitudinal regression models were used to identify the relationship between ESF coverage and amenable mortality rates in 1,622 municipalities in Brazil over the period 2000-12. Municipal health governance was measured using indicators from a public administration survey, and the resulting scores were used in interactions. Overall, increasing ESF coverage from 0 percent to 100 percent was associated with a reduction of 6.8 percent in rates of amenable mortality, compared with no increase in ESF coverage. The reductions were 11.0 percent for municipalities with the highest governance scores and 4.3 percent for those with the lowest scores. These findings suggest that strengthening local health governance may be vital for improving health services effectiveness and health outcomes in decentralized health systems.engProject HOPEMortalidadeCuidados primarios a saudeSistema de saúdeGestão clínicaMortalityPrimary Care healthHealth systemClinical managementMortalidadeCuidados primarios a saudeSistema de saúdeGestão clínicaLarge Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governanceinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/18988/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALHone and Large reductions in....pdfHone and Large reductions 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dc.title.pt_BR.fl_str_mv Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
title Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
spellingShingle Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
Hone, Thomas
Mortalidade
Cuidados primarios a saude
Sistema de saúde
Gestão clínica
Mortality
Primary Care health
Health system
Clinical management
Mortalidade
Cuidados primarios a saude
Sistema de saúde
Gestão clínica
title_short Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
title_full Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
title_fullStr Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
title_full_unstemmed Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
title_sort Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance
author Hone, Thomas
author_facet Hone, Thomas
Rasella, Davide
Barreto, Maurício Lima
Atun, Rifat
Majeed, Azeem
Millett, Christopher
author_role author
author2 Rasella, Davide
Barreto, Maurício Lima
Atun, Rifat
Majeed, Azeem
Millett, Christopher
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Hone, Thomas
Rasella, Davide
Barreto, Maurício Lima
Atun, Rifat
Majeed, Azeem
Millett, Christopher
dc.subject.other.pt_BR.fl_str_mv Mortalidade
Cuidados primarios a saude
Sistema de saúde
Gestão clínica
topic Mortalidade
Cuidados primarios a saude
Sistema de saúde
Gestão clínica
Mortality
Primary Care health
Health system
Clinical management
Mortalidade
Cuidados primarios a saude
Sistema de saúde
Gestão clínica
dc.subject.en.pt_BR.fl_str_mv Mortality
Primary Care health
Health system
Clinical management
dc.subject.decs.pt_BR.fl_str_mv Mortalidade
Cuidados primarios a saude
Sistema de saúde
Gestão clínica
description Imperial College de Londres, como Programa de doutorado de Thomas Hone, e parcialmente através da Da Saúde e do Ministério da Saúde do Brasil, como parte de uma Programa de pesquisa colaborativa sobre o sistema de saúde brasileiro. Sugerir uma edição Google Tradutor para empresas:Google Toolkit de tradução para appsTradutor de sitesGlobal Market Finder Sobre o Google TradutorComunidadeCelular Sobre o GooglePrivacidade e TermosAjudaEnviar feedback Imperial College London, as part of Thomas Hone’s PhD program, and partially through the Pan American Health Organization and the Brazilian Ministry of Health.
publishDate 2017
dc.date.accessioned.fl_str_mv 2017-05-22T13:37:44Z
dc.date.available.fl_str_mv 2017-05-22T13:37:44Z
dc.date.issued.fl_str_mv 2017
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv HONE, T. et al. Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance. Health Affairs, v. 36, n.1, p. 149-158, 2017.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/18988
dc.identifier.issn.pt_BR.fl_str_mv 1544-5208
dc.identifier.doi.none.fl_str_mv 10.1377/hlthaff.2016.0966
identifier_str_mv HONE, T. et al. Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance. Health Affairs, v. 36, n.1, p. 149-158, 2017.
1544-5208
10.1377/hlthaff.2016.0966
url https://www.arca.fiocruz.br/handle/icict/18988
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Project HOPE
publisher.none.fl_str_mv Project HOPE
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
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instacron_str FIOCRUZ
institution FIOCRUZ
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