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. 2017 Dec 4;16(1):209.
doi: 10.1186/s12939-017-0704-x.

Spatially balanced provision of health equipment: a cross-sectional study oriented to the identification of challenges to access promotion

Pedro Vasconcelos Amaral  1 , Thiago Augusto Hernandes Rocha  2 , Allan Claudius Queiroz Barbosa  3 , Adriana Lein  4 , João Ricardo Nickenig Vissoci  4
Affiliations

Spatially balanced provision of health equipment: a cross-sectional study oriented to the identification of challenges to access promotion

Pedro Vasconcelos Amaral et al. Int J Equity Health. .

Abstract

Background: Access to health services is in part defined by the spatial distribution of healthcare equipment. To ensure equity in the provision of health services, it is important to examine availability across different health care providers taking into account population demand. Given the importance of the equitable provision of health equipment, we evaluate its spatial distribution in Brazil.

Methods: This study is classified as cross-sectional with an ecological design. We evaluate Brazilian data on distance to available health equipment considering: dialysis machines (385), magnetic resonance imaging (MRI) (257), hospital beds (3675) and bone densitometers (429). We define two distance thresholds (50 km and 200 km) from a municipality to the center of services provision. The balance between infrastructure capacity and potential demand was evaluated to identify a lack or surplus of health services.

Results: The distribution of dialysis equipment and bone densitometers is not balanced across Brazilian states, and unmet demand is high. With respect to MRIs, the large capacity of this equipment results in a large excess of supply. However, this characteristic alone cannot account for excesses of supply of over 700%, as is the case of the Federal District when the range is limited to 50 km. At the same time, four states in the Northeastern region of Brazil show a net excess of demand. Some regions do not meet the standard amount of supply defined by Brazilian Ministry of Health. The quantity and distribution of hospital beds are not sufficient to provide full coverage to the population.

Conclusion: Our main focus was to evaluate the network of the provision of health equipment in Brazil, considering both private and public sectors conjointly. We take into account two main aspects of a spatially balanced health system: the regional availability of health equipment and the geographic distance between its demand and supply at the municipality level. Some regions do not meet the minimum requirement defined by the Brazilian Ministry of Health regarding the supply of health services.

Keywords: Health care evaluation mechanisms; Hospitals; Spatial analysis.

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Conflict of interest statement

Ethics approval and consent to participate

No human data were collected for the present study. All data used came from public secondary databases.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The range of a fictional health care network
Fig. 2
Fig. 2
Spatial distribution of health equipment, normalized by population/103
Fig. 3
Fig. 3
Excess of supply and demand considering maximum ranges of 50 km and 200 km in terms of % of state population: bone densitometers and hospital beds
Fig. 4
Fig. 4
Excess of supply and demand considering maximum ranges of 50 km and 200 km in terms of % of state population: dialysis machines and MRI
Fig. 5
Fig. 5
Percentage of the population served by the potential provision of bone densitometers
Fig. 6
Fig. 6
Percentage of the population served by the potential provision of hospital beds
Fig. 7
Fig. 7
Percentage of the population served by the potential provision of dialysis machines
Fig. 8
Fig. 8
Percentage of the population served by the potential provision of MRIs
See this image and copyright information in PMC

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