The effectiveness of the Brazilian health system: an evaluation through indicators of preventable conditions

Abstract

This article examines the effectiveness of the Brazilian health system based on indicators for conditions that are undesirable and preventable by health actions: 1) preventable deaths, 2) preventable cases and 3) preventable hospitalizations. To evaluate preventable deaths, the mortality rates of children under five years of age due to diarrhea and acute respiratory infections were examined. These data reveal the health status of a population group particularly responsive to primary and secondary preventative measures. To evaluate preventable cases, the AIDS incidence rate was considered because it is a major public health problem for which interventions have been developed to prevent the occurrence of new cases and to prevent existing cases from becoming seropositive. To evaluate preventable hospitalizations, data were examined for conditions characterized as sensitive to primary care, namely, the standardized rates of hospitalization for asthma and heart failure, both of which are preventable by proper ambulatory care. Although the incidence of AIDS remained stable between 1998 and 2010, the other indicators showed a steady downward trend, suggesting improvement in the effectiveness of the health system. However, strong regional disparities remain that are unfavorable to the poorest regions.