Primary healthcare expansion and mortality in Brazil’s urban poor: A cohort analysis of 1.2 million adults

Thomas Hone, Valeria Saraceni, Claudia Medina Coeli, Anete Trajman, Davide Rasella, Christopher Millett and Betina Durovni

PLOS Medicine, 2020, vol. 17, issue 10, 1-20

Abstract: Background: Expanding delivery of primary healthcare to urban poor populations is a priority in many low- and middle-income countries. This remains a key challenge in Brazil despite expansion of the country’s internationally recognized Family Health Strategy (FHS) over the past two decades. This study evaluates the impact of an ambitious program to rapidly expand FHS coverage in the city of Rio de Janeiro, Brazil, since 2008. Methods and findings: A cohort of 1,241,351 low-income adults (observed January 2010–December 2016; total person-years 6,498,607) with linked FHS utilization and mortality records was analyzed using flexible parametric survival models. Time-to-death from all-causes and selected causes were estimated for FHS users and nonusers. Models employed inverse probability treatment weighting and regression adjustment (IPTW-RA). Conclusions: FHS utilization in urban poor populations in Brazil was associated with a lower risk of death, with greater reductions among more deprived race/ethnic and socioeconomic groups. Increased investment in primary healthcare is likely to improve health and reduce health inequalities in urban poor populations globally. Thomas Hone and colleagues explore the Family Health Strategy for primary health care access in a low-income population.Why was this study done?: What did the researchers do and find?: What do these findings mean?:

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1003357

DOI: 10.1371/journal.pmed.1003357

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