The scope of practice of primary health care physicians in rural and urban areas in Brazil

Detalhes bibliográficos
Autor(a) principal: Stralen,Ana Cristina van
Data de Publicação: 2021
Outros Autores: Carvalho,Cristiana Leite, Girardi,Sábado Nicolau, Pierantoni,Celia Regina, Reis,Ilka Afonso, Cherchiglia,Mariangela Leal
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Cadernos de Saúde Pública
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2021000905002
Resumo: This study aimed to identify differences in the scope of practice of primary care physicians and find the main factors associated with expanded practice in rural and urban areas of Brazil. Data from an online survey with 2,277 primary care physicians, conducted between January and March 2016, were used. Differences regarding activities and procedures performed by physicians per area were verified using Kruskal-Wallis/Dunn’s post hoc and chi-square tests. Multivariate linear regression analyses were done using a bootstrap technique to identify the main factors associated with an expanded scope of practice. Regardless of the location, the results showed that the practices of the primary care physicians are below their competences. Rural physicians performed a higher number of procedures and activities compared with their peers from intermediate and urban municipalities. Within the overall sample, the variables related to a broader scope of practice included: male gender, work in rural municipalities, participation in training and continuing education programs and consultation of clinical protocols, articles and books. This study contributes with evidence that the medical scope of practice varies according to location. Recognizing and understanding the differences and associated factors for an expanded scope of practice is necessary to determine the skills and resources required for practice in rural and urban areas, collaborating in proposals of strategies to improve quality and access of health care services.
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spelling The scope of practice of primary health care physicians in rural and urban areas in BrazilScope of PracticePhysiciansHealth Services AccessibilityPrimary Health CareThis study aimed to identify differences in the scope of practice of primary care physicians and find the main factors associated with expanded practice in rural and urban areas of Brazil. Data from an online survey with 2,277 primary care physicians, conducted between January and March 2016, were used. Differences regarding activities and procedures performed by physicians per area were verified using Kruskal-Wallis/Dunn’s post hoc and chi-square tests. Multivariate linear regression analyses were done using a bootstrap technique to identify the main factors associated with an expanded scope of practice. Regardless of the location, the results showed that the practices of the primary care physicians are below their competences. Rural physicians performed a higher number of procedures and activities compared with their peers from intermediate and urban municipalities. Within the overall sample, the variables related to a broader scope of practice included: male gender, work in rural municipalities, participation in training and continuing education programs and consultation of clinical protocols, articles and books. This study contributes with evidence that the medical scope of practice varies according to location. Recognizing and understanding the differences and associated factors for an expanded scope of practice is necessary to determine the skills and resources required for practice in rural and urban areas, collaborating in proposals of strategies to improve quality and access of health care services.Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2021000905002Cadernos de Saúde Pública v.37 n.9 2021reponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZ10.1590/0102-311x00211520info:eu-repo/semantics/openAccessStralen,Ana Cristina vanCarvalho,Cristiana LeiteGirardi,Sábado NicolauPierantoni,Celia ReginaReis,Ilka AfonsoCherchiglia,Mariangela Lealeng2021-09-17T00:00:00Zoai:scielo:S0102-311X2021000905002Revistahttp://cadernos.ensp.fiocruz.br/csp/https://old.scielo.br/oai/scielo-oai.phpcadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2021-09-17T00:00Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.none.fl_str_mv The scope of practice of primary health care physicians in rural and urban areas in Brazil
title The scope of practice of primary health care physicians in rural and urban areas in Brazil
spellingShingle The scope of practice of primary health care physicians in rural and urban areas in Brazil
Stralen,Ana Cristina van
Scope of Practice
Physicians
Health Services Accessibility
Primary Health Care
title_short The scope of practice of primary health care physicians in rural and urban areas in Brazil
title_full The scope of practice of primary health care physicians in rural and urban areas in Brazil
title_fullStr The scope of practice of primary health care physicians in rural and urban areas in Brazil
title_full_unstemmed The scope of practice of primary health care physicians in rural and urban areas in Brazil
title_sort The scope of practice of primary health care physicians in rural and urban areas in Brazil
author Stralen,Ana Cristina van
author_facet Stralen,Ana Cristina van
Carvalho,Cristiana Leite
Girardi,Sábado Nicolau
Pierantoni,Celia Regina
Reis,Ilka Afonso
Cherchiglia,Mariangela Leal
author_role author
author2 Carvalho,Cristiana Leite
Girardi,Sábado Nicolau
Pierantoni,Celia Regina
Reis,Ilka Afonso
Cherchiglia,Mariangela Leal
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Stralen,Ana Cristina van
Carvalho,Cristiana Leite
Girardi,Sábado Nicolau
Pierantoni,Celia Regina
Reis,Ilka Afonso
Cherchiglia,Mariangela Leal
dc.subject.por.fl_str_mv Scope of Practice
Physicians
Health Services Accessibility
Primary Health Care
topic Scope of Practice
Physicians
Health Services Accessibility
Primary Health Care
description This study aimed to identify differences in the scope of practice of primary care physicians and find the main factors associated with expanded practice in rural and urban areas of Brazil. Data from an online survey with 2,277 primary care physicians, conducted between January and March 2016, were used. Differences regarding activities and procedures performed by physicians per area were verified using Kruskal-Wallis/Dunn’s post hoc and chi-square tests. Multivariate linear regression analyses were done using a bootstrap technique to identify the main factors associated with an expanded scope of practice. Regardless of the location, the results showed that the practices of the primary care physicians are below their competences. Rural physicians performed a higher number of procedures and activities compared with their peers from intermediate and urban municipalities. Within the overall sample, the variables related to a broader scope of practice included: male gender, work in rural municipalities, participation in training and continuing education programs and consultation of clinical protocols, articles and books. This study contributes with evidence that the medical scope of practice varies according to location. Recognizing and understanding the differences and associated factors for an expanded scope of practice is necessary to determine the skills and resources required for practice in rural and urban areas, collaborating in proposals of strategies to improve quality and access of health care services.
publishDate 2021
dc.date.none.fl_str_mv 2021-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2021000905002
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2021000905002
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0102-311x00211520
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
publisher.none.fl_str_mv Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
dc.source.none.fl_str_mv Cadernos de Saúde Pública v.37 n.9 2021
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
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