Equity in Health Policy for Persons With Disabilities in Brazil: Spatial Distribution of Specialised Rehabilitation Centres.

IF 1.9 4区医学 Q3 HEALTH POLICY & SERVICES

International Journal of Health Planning and Management Pub Date : 2025-07-18 DOI:10.1002/hpm.70010

Paulo Henrique Dos Santos Mota, Bianca Tomi Rocha Suda, Patricia Marques Moralejo Bermudi, Francisco Chiaravalloti Neto, Aylene Bousquat

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引用次数: 0

Abstract

Objective: To analyse the spatial distribution of Specialised Rehabilitation Centres (CERs) in Brazil, considering the prevalence of persons with disabilities (PWD), socioeconomic factors, and health financing.

Methods: An ecological study design was employed, using descriptive and Bayesian spatial regression analyses on data from 438 health regions in Brazil. The presence or absence of CERs in these regions was the main outcome. Covariates included PWD population, socioeconomic indicators, health service funding, and health system factors.

Results: The study revealed that CERs are present in only 32% of health regions, with significant associations between CER implementation and factors such as monthly per capita household income, health expenditure per inhabitant, and regional GDP. Notably, the increase in PWD numbers did not directly correlate with CER implementation at the regional level.

Conclusion: The implementation of CERs is influenced by economic and health service factors, not just by the prevalence of PWD. To improve equity in access, it is essential to prioritise CER implementation in regions with higher rehabilitation needs and better utilise available data on disability demographics. Comprehensive, integrated care for PWD requires interdisciplinary and intersectoral actions.

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巴西残疾人保健政策的公平性：专门康复中心的空间分布。

目的：分析巴西专业康复中心（CERs）的空间分布，考虑到残疾人（PWD）的患病率、社会经济因素和卫生融资。方法：采用生态研究设计，对巴西438个卫生区域的数据进行描述性和贝叶斯空间回归分析。这些区域是否存在cer是主要结果。协变量包括PWD人口、社会经济指标、卫生服务资金和卫生系统因素。结果：研究表明，只有32%的卫生区域实施了CER， CER的实施与家庭月人均收入、居民人均卫生支出和地区GDP等因素之间存在显著关联。值得注意的是，残疾人人数的增加与区域一级CER的实施没有直接关系。结论：CERs的实施受经济和卫生服务因素的影响，而不仅仅受PWD患病率的影响。为了改善可及性的公平性，必须优先在康复需求较高的地区实施CER，并更好地利用现有的残疾人口统计数据。残疾人的全面综合护理需要跨学科和跨部门的行动。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Health Planning and Management Multiple-

CiteScore

4.50

自引率

3.70%

发文量

197

期刊介绍： Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.