Evaluating the impact of contracting out basic health care services in the state of São Paulo, Brazil.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press in association with the London School of Hygiene and Tropical Medicine Country of Publication: England NLM ID: 8610614 Publication Model: Print Cited Medium: Internet ISSN: 1460-2237 (Electronic) Linking ISSN: 02681080 NLM ISO Abbreviation: Health Policy Plan
    • Publication Information:
      Original Publication: [Oxford] : Oxford University Press in association with the London School of Hygiene and Tropical Medicine, c1986-
    • Subject Terms:
      Contract Services/*statistics & numerical data ; Primary Health Care/*statistics & numerical data; Adolescent ; Adult ; Brazil ; Child ; Child Mortality ; Child, Preschool ; Hospitalization/statistics & numerical data ; Humans ; Infant ; Infant Mortality ; Local Government ; Middle Aged ; National Health Programs ; Preventive Health Services/statistics & numerical data
    • Abstract:
      As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services.This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use. The results show that implementation of the contracting out strategy significantly increases the number of primary health care appointments by approximately one appointment per user of the national health care system per year. Point estimates indicate a reducing effect on hospitalization for preventable diseases.
      (© The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)
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    • Contributed Indexing:
      Keywords: Brazil; SUS; child health; contracting out, difference-in-differences; health care service delivery; health care use; health systems development and reform; impact evaluation; national health care system; universal health care
    • Publication Date:
      Date Created: 20170419 Date Completed: 20180419 Latest Revision: 20231112
    • Publication Date:
      20240829
    • Accession Number:
      PMC5886252
    • Accession Number:
      10.1093/heapol/czw176
    • Accession Number:
      28419264