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Results of primary health care intervention for prevention of hospitalizations and mortality due to hypertension in Brazil, 2000–2015

Abstract

Aim

The article studies the effects of widening population access to primary health care related to hypertension indicators, taking advantage of a program led by the central government, based on community agent visits to households, adopted by the Brazilian decentralized municipalities (the Family Health Strategy).

Subjects and methods

Data on annual observations of 5560 municipalities (2000–2015) were used to estimate ordinary least square, fixed effect and quantile regression models to account for specific local differences and differences in levels of the program coverage.

Results

Our estimates indicate that access to a primary health system positively affects hypertension morbidity and mortality indicators, and program effects were higher in non-poor municipalities, possibly because of differences in governance and infrastructure at the local level.

Conclusion

Access to primary health care in developing countries has additional benefits than the reduction in mortality rates due to primary and secondary prevention, such as the benefits spillovers to non-communicable chronic diseases. However, lack of resources, socioeconomic inequalities, and deficiencies in primary health care operationalization in poor regions may limit the effect of primary health care programs.

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Acknowledgements

The authors would like to thank the Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazilian National Council for Scientific and Technologic Development, CNPq) for granting productivity scholarship.

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Correspondence to Marislei Nishijima.

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The authors declare that they have no conflict of interest.

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Appendix

Appendix

Table 6 Variable description
Table 7 OLS estimates for hypertension mortality and inpatient days due to hypertension per 1000 inhabitants

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Nishijima, M., Sarti, F.M. & Schor, A. Results of primary health care intervention for prevention of hospitalizations and mortality due to hypertension in Brazil, 2000–2015. J Public Health (Berl.) 28, 469–478 (2020). https://doi.org/10.1007/s10389-019-01020-4

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  • DOI: https://doi.org/10.1007/s10389-019-01020-4

Keywords

  • Primary health care
  • Hypertension
  • Public health system
  • Prevention
  • Universal health coverage