The scope of practice of primary health care physicians in rural and urban areas in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , |
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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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 |
_version_ |
1754115742521884672 |