Spatially balanced provision of health equipment: a cross-sectional study oriented to the identification of challenges to access promotion

International Journal for Equity in Health

Research

Thiago Augusto Hernandes Rocha¹  Pedro Vasconcelos Amaral²  João Ricardo Nickenig Vissoci³  Adriana Lein³  Allan Claudius Queiroz Barbosa⁴ 

[1] Center of post-graduate and Research in Administration Belo Horizonte, Federal University of Minas Gerais, Faculty of Economics Sciences, Belo Horizonte, Minas Gerais, Brazil;Centre for development and regional planning, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil;Division of Emergency Medicine, Duke University Health System, Duke Global Health Institute,, Duke University, North Carolina, Durham, USA;Faculty of Economics Sciences, Department of Business Administration, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil;

关键词: Spatial analysis;    Hospitals;    Health care evaluation mechanisms;   

DOI  :  10.1186/s12939-017-0704-x

 received in 2017-03-15, accepted in 2017-11-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAccess to health services is in part defined by the spatial distribution of healthcare equipment. To ensure equity in the provision of health services, it is important to examine availability across different health care providers taking into account population demand. Given the importance of the equitable provision of health equipment, we evaluate its spatial distribution in Brazil.MethodsThis study is classified as cross-sectional with an ecological design. We evaluate Brazilian data on distance to available health equipment considering: dialysis machines (385), magnetic resonance imaging (MRI) (257), hospital beds (3675) and bone densitometers (429). We define two distance thresholds (50 km and 200 km) from a municipality to the center of services provision. The balance between infrastructure capacity and potential demand was evaluated to identify a lack or surplus of health services.ResultsThe distribution of dialysis equipment and bone densitometers is not balanced across Brazilian states, and unmet demand is high. With respect to MRIs, the large capacity of this equipment results in a large excess of supply. However, this characteristic alone cannot account for excesses of supply of over 700%, as is the case of the Federal District when the range is limited to 50 km. At the same time, four states in the Northeastern region of Brazil show a net excess of demand. Some regions do not meet the standard amount of supply defined by Brazilian Ministry of Health. The quantity and distribution of hospital beds are not sufficient to provide full coverage to the population.ConclusionOur main focus was to evaluate the network of the provision of health equipment in Brazil, considering both private and public sectors conjointly. We take into account two main aspects of a spatially balanced health system: the regional availability of health equipment and the geographic distance between its demand and supply at the municipality level. Some regions do not meet the minimum requirement defined by the Brazilian Ministry of Health regarding the supply of health services.

【 授权许可】

CC BY   
© The Author(s). 2017