Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review

Detalhes bibliográficos
Autor(a) principal: Oliveira, João Paulo Alves
Data de Publicação: 2023
Outros Autores: Pacheco, Christina, Taves, Fábio Adriano Queirolo, Barbosa, Jessyka Mary Vasconcelos, Santos, Leonor Maria Pacheco
Tipo de documento: preprint
Idioma: por
Título da fonte: SciELO Preprints
Texto Completo: https://preprints.scielo.org/index.php/scielo/preprint/view/7369
Resumo: The distribution of doctors in Brazil is marked by inequalities, hindering full and universal access to healthcare, fundamental to SUS. The Mais Médicos Program (PMM) reached peak of emergency provision in 2016, with 18,800 doctors allocated to 4,509 municipalities, one of the largest interventions of its type. A rapid systematic review was carried out to gather evidence of the Program’s impacts on primary healthcare and on the assisted population’s health. 570 studies were extracted and the final selection included 32 articles. Regarding the Program’s effects, there was a rapid expansion in primary healthcare coverage, an improvement in comprehensiveness and humanization of healthcare, as well as significant impact on hospitalizations for primary healthcare sensitive conditions, which resulted in an approximate reduction of 23 thousand hospitalizations throughout three years, saving R$30 million for SUS. Critical points that undermined the Program’s potential impact were also identified: focus deviations; changes in priority criteria and undue replacement of hired doctors by PMM physicians, in addition to the disruption caused by the departure of 8,500 Cuban doctors in November 2018. It is estimated that the relaunch of the Mais Médicos Program, in 2023, especially based on existing evidence, will promote the continued progress of the Program.
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spelling Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review Efectos del Programa Mais Médicos en Atención Primaria y sus impactos en la salud: una revisión sistemática rápida.Efeitos do Programa Mais Médicos na Atenção Primária e seus impactos na saúde: uma revisão sistemática rápidaPrograma Mais MédicosAtenção Primária à SaúdeRevisão SistemáticaDistribuição de MédicosSistemas de SaúdeMais Médicos ProgramPrimary HealthcareSystematic ReviewDistribution of PhysiciansHealth SystemsPrograma Más MédicosAtención Primaria de SaludRevisión SistemáticaDistribución de MédicosSistemas de SaludThe distribution of doctors in Brazil is marked by inequalities, hindering full and universal access to healthcare, fundamental to SUS. The Mais Médicos Program (PMM) reached peak of emergency provision in 2016, with 18,800 doctors allocated to 4,509 municipalities, one of the largest interventions of its type. A rapid systematic review was carried out to gather evidence of the Program’s impacts on primary healthcare and on the assisted population’s health. 570 studies were extracted and the final selection included 32 articles. Regarding the Program’s effects, there was a rapid expansion in primary healthcare coverage, an improvement in comprehensiveness and humanization of healthcare, as well as significant impact on hospitalizations for primary healthcare sensitive conditions, which resulted in an approximate reduction of 23 thousand hospitalizations throughout three years, saving R$30 million for SUS. Critical points that undermined the Program’s potential impact were also identified: focus deviations; changes in priority criteria and undue replacement of hired doctors by PMM physicians, in addition to the disruption caused by the departure of 8,500 Cuban doctors in November 2018. It is estimated that the relaunch of the Mais Médicos Program, in 2023, especially based on existing evidence, will promote the continued progress of the Program.La distribución de médicos en Brasil es desigual, lo que dificulta el acceso pleno y universal a la salud, fundamental para el SUS. El Programa Mais Médicos (PMM) alcanzó su pico en 2016, con 18.088 médicos asignados a 4.509 municipios, una de las mayores intervenciones de su tipo en el mondo. Se llevó a cabo una revisión sistemática rápida para recopilar evidencia de los efectos del programa de Atención Primaria de Salud (APS) y sus impactos en la salud de la población atendida. Se extrajeron 570 estudios y fueran seleccionados 32 artículos. Acerca de los efectos del Programa, hubo una rápida ampliación de cobertura en APS, mejora en la integralidad y humanización de la atención de salud, así como un impacto en las hospitalizaciones a lo largo de tres años, ahorrando R$30 millones para el SUS. Puntos críticos que socavaban el impacto potencial del Programa fueran identificados: desviaciones en el enfoque; cambios en criterios de prioridad y sustitución indebida de médicos, además del trastorno provocado por la salida de 8.500 médicos cubanos en noviembre de 2018. Se estima que el relanzamiento del Programa Mais Médicos en 2023, especialmente con base en la evidencia existente, promoverá el progreso continuo del Programa.A distribuição de médicos no Brasil é marcada por desigualdades, prejudicando o acesso integral e universal à saúde, basilar para o SUS. O Programa Mais Médicos (PMM) atingiu o auge do provimento emergencial em 2016, com 18.088 médicos em 4.509 municípios, uma das maiores intervenções desse tipo no mundo. Realizou-se uma revisão rápida e sistemática para coletar evidências dos efeitos do Programa na Atenção Primária à Saúde (APS) e impactos na saúde da população atendida. Extraíram-se 570 estudos e a seleção final incluiu 32 artigos. Quanto aos efeitos do Programa, verificaram-se rápida expansão na cobertura da APS, melhoria na integralidade e humanização da atenção à saúde e impacto significativo nas internações por condições sensíveis à APS, gerando aproximadamente 23 mil internações ao longo de três anos, economizando R$ 30 milhões para o SUS. identificaram-se também pontos críticos que prejudicaram o potencial de impacto do Programa: desvios na focalização; mudanças nos critérios de prioridade e substituição indevida de médicos já contratados por outros do PMM, além da ruptura causada pela saída de 8.500 médicos cubanos em novembro de 2018. Estima-se que o relançamento do Programa Mais Médicos em 2023, principalmente a partir de evidências já existentes, promoverá a continuidade dos progressos do Programa.SciELO PreprintsSciELO PreprintsSciELO Preprints2023-11-17info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/736910.1590/SciELOPreprints.7369porhttps://preprints.scielo.org/index.php/scielo/article/view/7369/13846Copyright (c) 2023 João Paulo Alves Oliveira, Christina Pacheco, Fábio Adriano Queirolo Taves, Jessyka Mary Vasconcelos Barbosa, Leonor Maria Pacheco Santoshttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessOliveira, João Paulo AlvesPacheco, ChristinaTaves, Fábio Adriano QueiroloBarbosa, Jessyka Mary VasconcelosSantos, Leonor Maria Pachecoreponame:SciELO Preprintsinstname:Scientific Electronic Library Online (SCIELO)instacron:SCI2023-11-14T23:34:57Zoai:ops.preprints.scielo.org:preprint/7369Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2023-11-14T23:34:57SciELO Preprints - Scientific Electronic Library Online (SCIELO)false
dc.title.none.fl_str_mv Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
Efectos del Programa Mais Médicos en Atención Primaria y sus impactos en la salud: una revisión sistemática rápida.
Efeitos do Programa Mais Médicos na Atenção Primária e seus impactos na saúde: uma revisão sistemática rápida
title Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
spellingShingle Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
Oliveira, João Paulo Alves
Programa Mais Médicos
Atenção Primária à Saúde
Revisão Sistemática
Distribuição de Médicos
Sistemas de Saúde
Mais Médicos Program
Primary Healthcare
Systematic Review
Distribution of Physicians
Health Systems
Programa Más Médicos
Atención Primaria de Salud
Revisión Sistemática
Distribución de Médicos
Sistemas de Salud
title_short Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
title_full Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
title_fullStr Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
title_full_unstemmed Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
title_sort Effects of the Mais Médicos Program on Primary Healthcare and its impacts on health: a rapid systematic review
author Oliveira, João Paulo Alves
author_facet Oliveira, João Paulo Alves
Pacheco, Christina
Taves, Fábio Adriano Queirolo
Barbosa, Jessyka Mary Vasconcelos
Santos, Leonor Maria Pacheco
author_role author
author2 Pacheco, Christina
Taves, Fábio Adriano Queirolo
Barbosa, Jessyka Mary Vasconcelos
Santos, Leonor Maria Pacheco
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Oliveira, João Paulo Alves
Pacheco, Christina
Taves, Fábio Adriano Queirolo
Barbosa, Jessyka Mary Vasconcelos
Santos, Leonor Maria Pacheco
dc.subject.por.fl_str_mv Programa Mais Médicos
Atenção Primária à Saúde
Revisão Sistemática
Distribuição de Médicos
Sistemas de Saúde
Mais Médicos Program
Primary Healthcare
Systematic Review
Distribution of Physicians
Health Systems
Programa Más Médicos
Atención Primaria de Salud
Revisión Sistemática
Distribución de Médicos
Sistemas de Salud
topic Programa Mais Médicos
Atenção Primária à Saúde
Revisão Sistemática
Distribuição de Médicos
Sistemas de Saúde
Mais Médicos Program
Primary Healthcare
Systematic Review
Distribution of Physicians
Health Systems
Programa Más Médicos
Atención Primaria de Salud
Revisión Sistemática
Distribución de Médicos
Sistemas de Salud
description The distribution of doctors in Brazil is marked by inequalities, hindering full and universal access to healthcare, fundamental to SUS. The Mais Médicos Program (PMM) reached peak of emergency provision in 2016, with 18,800 doctors allocated to 4,509 municipalities, one of the largest interventions of its type. A rapid systematic review was carried out to gather evidence of the Program’s impacts on primary healthcare and on the assisted population’s health. 570 studies were extracted and the final selection included 32 articles. Regarding the Program’s effects, there was a rapid expansion in primary healthcare coverage, an improvement in comprehensiveness and humanization of healthcare, as well as significant impact on hospitalizations for primary healthcare sensitive conditions, which resulted in an approximate reduction of 23 thousand hospitalizations throughout three years, saving R$30 million for SUS. Critical points that undermined the Program’s potential impact were also identified: focus deviations; changes in priority criteria and undue replacement of hired doctors by PMM physicians, in addition to the disruption caused by the departure of 8,500 Cuban doctors in November 2018. It is estimated that the relaunch of the Mais Médicos Program, in 2023, especially based on existing evidence, will promote the continued progress of the Program.
publishDate 2023
dc.date.none.fl_str_mv 2023-11-17
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