Medical school expansion policies: educational access and physician distribution

• Autor(a) principal: Figueiredo, Alexandre Medeiros
• Data de Publicação: 2019
• Outros Autores: McKinley, Danette Waller, Lima, Kenio Costa de, Azevedo, George Dantas de
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRN
• Texto Completo: https://repositorio.ufrn.br/handle/123456789/31462
• topic: Medical Education; Workforce; Career Choice; Health Policy; Healthcare Disparities

Introduction: many countries areemploying strategies intended to reducemaldistribution of health workers andinequities. The purpose of this study was toanalyse the impact of expansion policies ofmedical schools on regional inequalities inthe distribution of undergraduate class sizes,and the capacity to attract and retain doctorsand to expand health facilities. Methods: we conducted a descriptive analysisto compare the distribution of undergraduateplaces in 2007 and 2016 to determine theimpact of targeted expansion policies oninequalities in access to medical education inBrazil. A group of municipalities with newmedical schools (n = 54) and a control groupwithout medical schools (n = 408) werecompared to analyse impacts of expansion inthe health sector. We compared the increase inthe number of physicians per 1000 inhabitantsand health establishments per inhabitantsbetween 2007 and 2016 based on these twogroups. We also analysed the relationshipbetween geographic distance from the statecapital and capacity to attract physicians. Results: there was a decrease in theregional inequalities of undergraduateplaces in medical schools; the greatestincrease in the places per 1000 inhabitantswas in municipalities of between 50 000 and100 000 inhabitants. Municipalities with newmedical schools showed an increase inphysicians per 1000 inhabitants and inhealth establishments per inhabitant ratio,demonstrating the potential to attract andretain doctors, as well as strengtheningthe health infrastructure. Municipalitiesmore distant from state capitals showed agreater increase in physician : inhabitantratio. Discussion: countries with healthworkforce shortages and inequalities in theirdistribution might consider public financingand regulation policies for expansion ofmedical schools as a strategy to attract andretain professionals. Early results in Brazilshowed that such strategies could strengthenservice networks in deprived areas, supportingimplementation of Universal Healthcare Coverage