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Primary health care coverage in Brazil: Assessment of the Family Health Program impacts on mortality at municipality level

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  • Maria Dolores Montoya Diaz
  • Adriano Dutra Teixeira, Fernando Antonio Slaibe Postali, Natalia Nunes Ferreira-Batista, Rodrigo Mor

Abstract

The main purpose of this paper is to analyse the direct impacts of Family Health Strategy / Program (PSF) on mortality related to diseases / conditions for which access to effective primary care can reduce the likelihood of more severe outcomes and quality of vital information (Chap 18 of ICD 10). The measure of coverage is the number of teams deployed by population. We worked with individual data from the Brazilian Ministry of Health (Datasus) aggregated to municipal level. To address the endogeneity of the coverage, we estimated a fixed effect model with instrumental variables. The instruments employed are dummies that capture the political alignment between majors and the state governor, between majors and the president, and between state governor and the president. Our results show no significant effects for stroke, asthma, other diseases from respiratory tract and kidney diseases. On the other hand, there are significant effects for conditions related to Brazilian list of avoidable hospital admissions, hypertension and diabetes, coronary disease, cardiac insufficiency, diabetes complications and bacterial pneumonia, indicating that PSF is effective in reducing avoidable mortality for that causes. The results obtained for some metropolitan region municipalities suggest that it seems that heterogeneities may exist.

Suggested Citation

  • Maria Dolores Montoya Diaz & Adriano Dutra Teixeira, Fernando Antonio Slaibe Postali, Natalia Nunes Ferreira-Batista, Rodrigo Mor, 2019. "Primary health care coverage in Brazil: Assessment of the Family Health Program impacts on mortality at municipality level," Working Papers, Department of Economics 2019_42, University of São Paulo (FEA-USP), revised 12 Aug 2021.
    • Handle: RePEc:spa:wpaper:2019wpecon42
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    References listed on IDEAS

    as
    1. Aquino, R. & De Oliveira, N.F. & Barreto, M.L., 2009. "Impact of the Family Health Program on infant mortality in brazilian municipalities," American Journal of Public Health, American Public Health Association, vol. 99(1), pages 87-93.
    2. Brollo, Fernanda & Nannicini, Tommaso, 2012. "Tying Your Enemy's Hands in Close Races: The Politics of Federal Transfers in Brazil," American Political Science Review, Cambridge University Press, vol. 106(4), pages 742-761, November.
    3. Giovanni Cerulli, 2015. "ctreatreg: Command for fitting dose–response models under exogenous and endogenous treatment," Stata Journal, StataCorp LP, vol. 15(4), pages 1019-1045, December.
    4. Denise de Fátima Barros Cavalcante & Valéria Silva Cândido Brizon & Livia Fernandes Probst & Marcelo de Castro Meneghim & Antonio Carlos Pereira & Gláucia Maria Bovi Ambrosano, 2018. "Did the Family Health Strategy have an impact on indicators of hospitalizations for stroke and heart failure? Longitudinal study in Brazil: 1998-2013," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-10, June.
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    Cited by:

    1. Natalia Nunes Ferreira-Batista & Maria Dolores Montoya Diaz, Adriano Dutra Teixeira, Fernando Antonio Slaibe Postali, Rodrigo Serra, 2019. "Impact of ESF coverage on general health at the individual level - Metropolitan areas," Working Papers, Department of Economics 2019_43, University of São Paulo (FEA-USP).

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    More about this item

    Keywords

    Family Health Program (PSF); Mortality; Datasus databases; Impact Evaluation; Fixed Effects Instrumental Variables; Dose-Response Model;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation

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