Distribution of public investment in physical therapy and supplementary health coverage in Brazil: historical series from 2010 to 2015

ABSTRACT This study aims to describe the profile of public investments in physical therapy and to verify the correlation between these investments and the health insurance coverage rate in major Brazilian regions and Federation units, between 2010 and 2015. Data concerning the approved public investments by region and Federation units according to physical therapy attendance were obtained in the Outpatient Information System of the Unified Health System, in the website of the Department of Informatics of the Unified Health System (Datasus). The information corresponding to the health insurance coverage rate was obtained in the Supplementary Health Information sector, available on the National Supplementary Health Agency website. Data were analyzed and the Spearman correlation test was held with a significance level of 5.00% to show a correlation between investment distribution and health insurance coverage rate. The mean per capita application in Brazil, in Brazilian Reais, of financial resources in physical therapy attendances, over the five years analyzed, was R$ 117.16 (±3.52). Among the regions, and for the same period, the South region presented the highest mean per capita (R$ 129.95±5.30), followed in descending order by the Southeast (R$ 124.22±3.69), Northeast (R$ 118.98±7.53), North (R$ 89.43±3.01), and Midwest (R$ 77.09±6.54) regions. The mean coverage by private health insurance varied from 6.20% (Acre) to 43.35% (São Paulo). Apparently, no correlation exists between private health insurance coverage and public investment in physical therapy services.

摘要 本研究旨在刻画2010—2015年巴西各主要地区及联邦单位的公共物理治疗投资概况，并验证此类投资与健康保险覆盖率之间的相关性。研究数据来源分为两部分：其一，按地区及联邦单位划分、依据物理治疗就诊人次核定的获批公共投资数据，取自巴西统一健康系统信息部（Datasus）官网的统一健康系统门诊信息系统；其二，健康保险覆盖率相关数据，取自国家补充健康保险局官网的补充健康信息板块。本研究对上述数据开展分析，并采用显著性水平为5.00%的斯皮尔曼相关性检验，以探究投资分布与健康保险覆盖率之间的关联。2010—2015年五年间，巴西全国物理治疗就诊相关财政投入的人均均值为117.16雷亚尔（±3.52）。同期各地区中，南部地区的人均投入均值最高，达129.95雷亚尔（±5.30）；其余地区按人均投入均值从高到低依次为东南部（124.22雷亚尔±3.69）、东北部（118.98雷亚尔±7.53）、北部（89.43雷亚尔±3.01）以及中西部（77.09雷亚尔±6.54）。私人健康保险的平均覆盖率介于6.20%（阿克里州）至43.35%（圣保罗州）之间。本研究未发现私人健康保险覆盖率与公共物理治疗服务投资之间存在显著相关性。