Equity in Health Policy for Persons With Disabilities in Brazil: Spatial Distribution of Specialised Rehabilitation Centres

Paulo Henrique dos Santos Mota, Bianca Tomi Rocha Suda, Patricia Marques Moralejo Bermudi, Francisco Chiaravalloti Neto and Aylene Bousquat

International Journal of Health Planning and Management, 2025, vol. 40, issue 6, 1279-1288

Abstract: Objective To analyse the spatial distribution of Specialised Rehabilitation Centres (CERs) in Brazil, considering the prevalence of persons with disabilities (PWD), socioeconomic factors, and health financing. Methods An ecological study design was employed, using descriptive and Bayesian spatial regression analyses on data from 438 health regions in Brazil. The presence or absence of CERs in these regions was the main outcome. Covariates included PWD population, socioeconomic indicators, health service funding, and health system factors. Results The study revealed that CERs are present in only 32% of health regions, with significant associations between CER implementation and factors such as monthly per capita household income, health expenditure per inhabitant, and regional GDP. Notably, the increase in PWD numbers did not directly correlate with CER implementation at the regional level. Conclusion The implementation of CERs is influenced by economic and health service factors, not just by the prevalence of PWD. To improve equity in access, it is essential to prioritise CER implementation in regions with higher rehabilitation needs and better utilise available data on disability demographics. Comprehensive, integrated care for PWD requires interdisciplinary and intersectoral actions.

Date: 2025
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