O Programa Mais Médicos para o Brasil e os resultados para o acesso da população aos cuidados de Saúde

Abstract

Public health in Brazil has been untiringly debated by authorities and the population. For over 30 years there were several plans that targeted improvements in the provision of services and in Brazilian’s population health. The Programa Mais Médicos (More Doctors Program) was recently implemented, thought approval of the Law n.º 12.871/2013, from October 22. In this context, this paper develops an impact assessment of the program’s first axis, the Programa Mais Médicos para o Brasil (PMMB) (More Doctors for Brazil Program), on the expansion of population access to healthcare at the three levels of care. For that aim, it was used two econometrics methodologies, ordinary least squares and fuzzy regression discontinuity design, which is specifically designed for non-random samples. The conclusions obtained from the analysis of selected indicators, in primary care (medical consultation, home visit, diabetes and hypertension care, and emergency and hospitalization referral) and in the hospital sector (hospitalization due to complications of diabetes and hospitalization for other causes), vary according to the econometric methodology used. The results obtained by ordinary least squares indicate that the PMMB reached the proposed goal of expanding access to healthcare in primary care in 2015 for all samples. However, the results obtained by fuzzy discontinuous regression are less favorable for municipalities whose percentage of extreme poverty is closer to the cutoff point (20%) relative to the eligibility to the program by criteria of extreme poverty. The benefits associated to the program's existence in terms of access to healthcare were therefore relatively lower in those municipalities where the poverty rate is closer to the cut-off point. Therefore, it is not recommended to expand the PMMB to municipalities whose percentage of extreme poverty is less than 20%.