Artigos Acadêmicos e Noticiosos
URI permanente desta comunidadehttps://repositorio.insper.edu.br/handle/11224/3226
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Artigo Científico Is primary health care worth it in the long run? Evidence from Brazil(2023) Ferreira-Batista, Natalia Nunes; Teixeira, Adriano Dutra; Diaz, Maria Dolores Montoya; Postali, Fernando Antonio Slaibe; Moreno-Serra, Rodrigo; Love-Koh, JamesThis paper assesses whether Brazilian primary health care is worth it in the long-run by estimating the accumulated costs and benefits of its flagship, the Family Health Strategy program (ESF). We employ an alternative strategy centered on years of exposure to the program to incorporate its dynamics. We also account for the program's heterogeneity with respect to the remuneration of ESF health teams and the intensity of coverage across Brazilian municipalities, measure by the number of people assisted by each ESF team, on average. To address heterogeneity in professional earnings, this paper employs, for the first time, a dataset containing the remuneration of professionals allocated to all ESF teams nationwide. The benefits are measured by the avoided deaths and hospitalizations due to causes sensitive to primary care. Results suggest that the net monetary benefit of the program is positive on average, with an optimum time of exposure of approximately 16 years. Significant heterogeneities in cost-benefit results were found since costs outweigh benefits in localities where the coverage is low intensive. On the other hand, the benefits outweigh the costs by 22.5% on average in municipalities with high intensive coverage.Artigo Científico Assessment of the association between the Brazilian family health strategy and adult mortality(2022) Diaz, Maria Dolores Montoya; Teixeira, Adriano Dutra; Postali, Fernando Antonio Slaibe; Ferreira-Batista, Natalia Nunes; Moreno-Serra, RodrigoThis study aimed to analyse a wide range of related health problems that respond favourably to efficient primary care treatment among adults. We evaluate the direct impact of the Family Health Strategy (ESF) in Brazil on mortality of adults aged 25–64 years related to conditions for which access to effective primary care can reduce the likelihood of more severe outcomes. Additionally, we discuss heterogeneous effects associated with different intensities of the programme. To address these issues, we estimated a model with variation at the municipal level of the ESF expansion, including municipal-fixed effects, municipal specific trends and year-fixed effects. Our results show that a higher intensity of ESF is associated with reduced mortality by all conditions sensitive to primary care and for some diseases, especially after some years: avoidable conditions, asthma, heart failure, cerebrovascular diseases and gastrointestinal ulcer, infectious gastroenteritis and complications, diseases of the lower airways, hypertension and diabetes. As a public policy view, these results help understand how a nationwide primary care strategy can help mitigate mortality and emphasize the role of having sufficient health teams to attend to the population.