| Author | Hone, Thomas | |
| Author | Rasella, Davide | |
| Author | Barreto, Maurício Lima | |
| Author | Atun, Rifat | |
| Author | Majeed, Azeem | |
| Author | Millett, Christopher | |
| Access date | 2017-05-22T13:37:44Z | |
| Available date | 2017-05-22T13:37:44Z | |
| Document date | 2017 | |
| Citation | HONE, T. et al. Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance. Health Affairs, v. 36, n.1, p. 149-158, 2017. | pt_BR |
| ISSN | 1544-5208 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/18988 | |
| Sponsorship | Imperial College de Londres, como
Programa de doutorado de Thomas Hone, e parcialmente através da
Da Saúde e do Ministério da Saúde do Brasil, como parte de uma
Programa de pesquisa colaborativa sobre o sistema de saúde brasileiro.
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Imperial College London, as part of Thomas Hone’s PhD program, and partially through the Pan American Health Organization and the Brazilian Ministry of Health. | pt_BR |
| Language | eng | pt_BR |
| Publisher | Project HOPE | pt_BR |
| Rights | open access | pt_BR |
| Subject in Portuguese | Mortalidade | pt_BR |
| Subject in Portuguese | Cuidados primarios a saude | pt_BR |
| Subject in Portuguese | Sistema de saúde | pt_BR |
| Subject in Portuguese | Gestão clínica | pt_BR |
| Title | Large Reductions In Amenable Mortality Associated With Brazil's Primary Care Expansion And Strong Health Governance | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1377/hlthaff.2016.0966 | |
| Abstract | Strong health governance is key to universal health coverage. However, the relationship between governance and health system performance is underexplored. We investigated whether expansion of the Brazilian Estratégia de Saúde da Família (ESF; family health strategy), a community-based primary care program, reduced amenable mortality (mortality avoidable with timely and effective health care) and whether this association varied by municipal health governance. Fixed-effects longitudinal regression models were used to identify the relationship between ESF coverage and amenable mortality rates in 1,622 municipalities in Brazil over the period 2000-12. Municipal health governance was measured using indicators from a public administration survey, and the resulting scores were used in interactions. Overall, increasing ESF coverage from 0 percent to 100 percent was associated with a reduction of 6.8 percent in rates of amenable mortality, compared with no increase in ESF coverage. The reductions were 11.0 percent for municipalities with the highest governance scores and 4.3 percent for those with the lowest scores. These findings suggest that strengthening local health governance may be vital for improving health services effectiveness and health outcomes in decentralized health systems. | pt_BR |
| Affilliation | School of Public Health. Imperial College London. Public Health Policy Evaluation Unit. Department of Primary Care and Public Health. London, England / Harvard T. H. Chan School of Public Health. Boston, Massachusetts | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil | pt_BR |
| Affilliation | Harvard University. Cambridge, Massachusetts, EUA | pt_BR |
| Affilliation | Imperial College London. Department of Primary Care and Public Health. London, England | pt_BR |
| Affilliation | Imperial College London. Center for Epidemiological Studies in Health and Nutrition. Department of Primary Care and Public Health. London, England / Universidade de São Paulo. Institute of Social Medicine. Department of Epidemiology. São Paulo, SP, Brasil / Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil | pt_BR |
| Subject | Mortality | pt_BR |
| Subject | Primary Care health | pt_BR |
| Subject | Health system | pt_BR |
| Subject | Clinical management | pt_BR |
| DeCS | Mortalidade | pt_BR |
| DeCS | Cuidados primarios a saude | pt_BR |
| DeCS | Sistema de saúde | pt_BR |
| DeCS | Gestão clínica | pt_BR |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
