Major Expansion Of Primary Care In Brazil Linked To Decline In Unnecessary Hospitalization

In 1994 Brazil launched what has since become the world's largest community-based primary health care program. Under the Family Health Program, teams consisting of at least one physician, one nurse, a medical assistant, and four to six trained community health agents deliver most of their servi...

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Bibliographic Details
Published in:Health Affairs 2010-12, Vol.29 (12), p.2149-2160
Main Authors: Macinko, James, Dourado, Inês, Aquino, Rosana, Bonolo, Palmira de Fátima, Lima-Costa, Maria Fernanda, Medina, Maria Guadalupe, Mota, Eduardo, de Oliveira, Veneza Berenice, Turci, Maria Aparecida
Format: Article
Language:English
Subjects:
Ambulatory care
Asthma
Blood pressure
Brazil
Cardiovascular disease
Cardiovascular diseases
Cholesterol
Chronic illnesses
Clinical practice guidelines
Clinics
Community health services
Diabetes
Disease management
Diseases
Emergency medical services
Health care
Health care access
Health care policy
Health promotion
Health services
Hospitalization
Hospitals
Hypertension
Medical personnel
Medical service
Mortality
Municipalities
Neighborhoods
Patients
Physicians
Population
Primary care
Public health
Risk factors
Smoking
Smoking cessation
Studies
Teams
Trends
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Summary:In 1994 Brazil launched what has since become the world's largest community-based primary health care program. Under the Family Health Program, teams consisting of at least one physician, one nurse, a medical assistant, and four to six trained community health agents deliver most of their services at community-based clinics. They also make regular home visits and conduct neighborhood health promotion activities. This study finds that during 1999-2007, hospitalizations in Brazil for ambulatory care-sensitive chronic diseases, including cardiovascular disease, stroke, and asthma, fell at a rate that was statistically significant and almost twice the rate of decline in hospitalizations for all other causes. In municipalities with high Family Health Program enrollment, chronic disease hospitalization rates were 13 percent lower than in municipalities with low enrollment, when other factors were held constant. These results suggest that the Family Health Program has improved health system performance in Brazil by reducing the number of potentially avoidable hospitalizations. [PUBLICATION ABSTRACT]
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2010.0251