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Equity in Health Policy for Persons With Disabilities in Brazil: Spatial Distribution of Specialised Rehabilitation
Paulo Henrique Dos Santos Mota1, Bianca Tomi Rocha Suda2, Patricia Marques Moralejo Bermudi2
1Department of Policies, Management and Health, School of Public Health, University of São Paulo, São Paulo, Brazil.
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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