Overview on and Contextual Determinants of Medical Residencies in North Brazil-Reference-Cited by-同舟云学术

Overview on and Contextual Determinants of Medical Residencies in North Brazil

Published:2023-04-11 Issue:8 Volume:11 Page:1083
ISSN:2227-9032
Container-title:Healthcare
language:en
Short-container-title:Healthcare

Author:

Guimarães Rafael Alves¹²³^ORCID,Silva Ana Luísa Guedes de França e³⁴,Naghettini Alessandra Vitorino³⁴^ORCID,Neves Heliny Carneiro Cunha¹³,Arantes Fernanda Paula³⁵^ORCID,Borges Junior Cândido Vieira³⁵^ORCID,Silva Filho Antônio Isidro da³⁶,de Castro Alessandra Rodrigues Moreira⁷

Affiliation:

1. Nursing School, Federal University of Goiás, Goiânia 74690-900, Brazil

2. Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia 74690-900, Brazil

3. Center for Innovation in Education and Health Work Management, Federal University of Goiás, Goiânia 74690-900, Brazil

4. Medical School, Federal University of Goiás, Goiânia 74690-900, Brazil

5. Business, Accounting, and Economic Sciences Schools, Federal University of Goiás, Goiânia 74690-900, Brazil

6. Business, Accounting, Economics, and Public Management Schools, University of Brasília, Brasília 70910-900, Brazil

7. Ministry of Health, Brasília 70058-900, Brazil

Abstract

The aim of this study was to analyze the scenario of medical residency programs (MRPs) in the north region of Brazil as well as the contextual determinants (socioeconomic, structural, and epidemiological) influencing the number of MRPs in this region. An ecological study was conducted using MRPs data from 2022. This study used multiple data sources. MRP indicators were described based on the Brazilian state and specialty. The dependent variable was the number of MRPs. The independent variables included sociodemographic, structural, and epidemiological factors. Poisson regression was performed to analyze the association between contextual variables and the number of MRPs. The results showed that only 3.6% of the municipalities had authorized MRPs. The idleness rate in the region was 46.0%, with family and community medicine as the specialties with the greatest idleness. The total density of authorized vacancies in the MRPs was 14.0 vacancies per 100,000 inhabitants. The models showed that with each increase of one unit of the vulnerability index (Socioeconomic Index in the Geographic Context for Health Studies—GeoSES), the number of MRPs increased, ranging from 8122 (p value < 0.001) to 11,138 (p value < 0.001). With each increase in undergraduate degrees in medicine, the number of MRPs increased by 0.945 (p value < 0.001). With each increase of 1 physician per 1000 population, the number of MRPs increased from 0.537 (p value < 0.001) to 0.845 (p value < 0.001). With each increase of one unit in general hospitals, specialized hospitals, teaching hospitals, and primary healthcare units, the number of MRPs increased by 0.176 (p value < 0.001), 0.168 (p value < 0.001), 0.022 (p value < 0.001) and 0.032 (p value < 0.001), respectively. Finally, with each increase of one death per 100,000 inhabitants, the overall mortality rate increased, ranging from 0.006 (p value < 0.001) to 0.022 (p value < 0.001). The study showed a low supply of MRPs in the northern region, a high rate of idleness, and important socioeconomic, structural, and epidemiological determinants of the number of MRPs.

Funder

National Health Fund (Fundo Nacional de Saúde–FNS) of Brazil

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

Link

https://www.mdpi.com/2227-9032/11/8/1083/pdf

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