You do not have permission to edit this page, for the following reasons:

This IP address has been blocked from editing Wikipedia.
This does not affect your ability to read Wikipedia pages.
Most people who see this message have done nothing wrong. Some kinds of blocks restrict editing from specific service providers or telecom companies in response to recent abuse or vandalism, and can sometimes affect other users who are unrelated to that abuse. Review the information below for assistance if you do not believe that you have done anything wrong.

The IP address or range 54.163.0.0/16 has been blocked (disabled) by ‪Blablubbs‬ for the following reason(s):

The IP address that you are currently using has been blocked because it is believed to be a web host provider or colocation provider. To prevent abuse, web hosts and colocation providers may be blocked from editing Wikipedia.
You will not be able to edit Wikipedia using a web host or colocation provider because it hides your IP address, much like a proxy or VPN.
We recommend that you attempt to use another connection to edit. For example, if you use a proxy or VPN to connect to the internet, turn it off when editing Wikipedia. If you edit using a mobile connection, try using a Wi-Fi connection, and vice versa. If you are using a corporate internet connection, switch to a different Wi-Fi network. If you have a Wikipedia account, please log in.
If you do not have any other way to edit Wikipedia, you will need to request an IP block exemption.

How to appeal if you are confident that your connection does not use a colocation provider's IP address:
If you are confident that you are not using a web host, you may appeal this block by adding the following text on your talk page: ((unblock|reason=Caught by a colocation web host block but this host or IP is not a web host. My IP address is _______. Place any further information here. ~~~~)). You must fill in the blank with your IP address for this block to be investigated. Your IP address can be determined here. Alternatively, if you wish to keep your IP address private you can use the unblock ticket request system. There are several reasons you might be editing using the IP address of a web host or colocation provider (such as if you are using VPN software or a business network); please use this method of appeal only if you think your IP address is in fact not a web host or colocation provider.

Administrators: The IP block exemption user right should only be applied to allow users to edit using web host in exceptional circumstances, and requests should usually be directed to the functionaries team via email. If you intend to give the IPBE user right, a CheckUser needs to take a look at the account. This can be requested most easily at SPI Quick Checkuser Requests. Unblocking an IP or IP range with this template is highly discouraged without at least contacting the blocking administrator.

This block will expire on 17:28, 10 March 2024.

Even when blocked, you will usually still be able to edit your user talk page, as well as email administrators and other editors.

For information on how to proceed, please read the FAQ for blocked users and the guideline on block appeals. The guide to appealing blocks may also be helpful.

Other useful links: Blocking policy · Help:I have been blocked
Your IP address is in a range that has been blocked on all Wikimedia Foundation wikis. The block was made by ‪Jon Kolbert‬. The reason given is Open proxy/Webhost: See the help page if you are affected .
- Start of block: 18:27, 12 November 2023
- Expiry of block: 18:27, 12 November 2028
Your current IP address is 54.163.179.242. The blocked range is 54.163.0.0/16. Please include all above details in any queries you make. If you believe you were blocked by mistake, you can find additional information and instructions in the No open proxies global policy. Otherwise, to discuss the block please post a request for review on Meta-Wiki. You could also send an email to the stewards VRT queue at stewards@wikimedia.org including all above details.

You can view and copy the source of this page:

((Short description|Overview of the health care system in Brazil))
((More citations needed|date=May 2021))
'''Healthcare in [[Brazil]]''' is a constitutional right.<ref>Ministério do Planejamento website, [http://www.conselho.saude.gov.br/14cns/docs/constituicaofederal.pdf "Constituição Federal (Artigos 196 a 200)"].</ref> It is provided by both private and government institutions. The Health Minister administers national health policy. [[Primary healthcare]] remains the responsibility of the federal government, elements of which (such as the operation of hospitals) are overseen by individual [[States of Brazil|states]]. Public healthcare is provided to all [[Brazilian nationality law|Brazilian permanent residents]] and foreigners in Brazilian territory through the National Healthcare System, known as the [[Sistema Único de Saúde|Unified Health System]] (((lang-pt|Sistema Único de Saúde)), SUS). The SUS is universal and free for everyone.

==History==
The National Ministry of Health was founded in 1953.<ref name=":0">((Citation |last=Falleti |first=Tulia G. |title=Infiltrating the State: The Evolution of Health Care Reforms in Brazil, 1964–1988 |date=2009 |url=https://www.cambridge.org/core/books/explaining-institutional-change/infiltrating-the-state-the-evolution-of-health-care-reforms-in-brazil-19641988/6ABB8227C9422880A3ADC07A5F94C6D7 |work=Explaining Institutional Change: Ambiguity, Agency, and Power |pages=38–62 |editor-last=Mahoney |editor-first=James |publisher=Cambridge University Press |isbn=978-0-521-11883-5 |editor2-last=Thelen |editor2-first=Kathleen))</ref>

The authoritarian military government introduced health care reforms in the 1970s to extend its control and legitimacy over the North and Northeast of Brazil where the military had limited presence. Until 1988, the health care system was centralized in the hands of the federal government and limited in its health care coverage. Prior to 1988, health care services were provided by the private sector, public sector and the social security sector.<ref name=":0" />

The 1988 Constitution and subsequent reforms in the 1990s established universal health care coverage and a decentralization of health care delivery at the municipal level.<ref name=":0" />

==Healthcare system==
[[File:Hospital Sarah Kubitschek 01.jpg|thumb|right|Sarah Kubitschek Hospital, [[Brasília]]]]
[[File:Beneficência Portugueza.jpg|thumb|right|Portuguese Hospital, [[Porto Alegre]]]]
[[Image:Memorial Medicina Pernambuco.jpg|right|thumb|Memorial of Medicine, [[Recife]]]]
[[File:Hospital Albert Einstein.jpg|thumb|right|Albert Einstein Hospital, [[São Paulo]]]]
[[File:Hospitalbelohorizonte.JPG|thumb|right|Hospital in [[Belo Horizonte]]]]
[[File:Maternidade Januário Cicco.JPG|thumb|right|Maternity hospital, [[Natal, Rio Grande do Norte|Natal]]]]
National health policies and plans: The national health policy is based on the Federal [[Brazilian Constitution|Constitution of 1988]], which sets out the principles and directives for the delivery of healthcare in the country through the [[Sistema Único de Saúde|Unified Health System]] (SUS). Under the constitution, the activities of the federal government are to be based on multiyear plans approved by the national congress for four-year periods. The essential objectives for the health sector were improvement of the overall health situation, with emphasis on reduction of [[child mortality]], and political-institutional reorganization of the sector, with a view to enhancing the operative capacity of the SUS. The plan for the next period (2000–2003) reinforces the previous objectives and prioritizes measures to ensure access at activities and services, improve care, and consolidate the decentralization of SUS management. 
===Health sector reform===
The current legal provisions governing the operation of the health system, instituted in 1996, seek to shift responsibility for administration of the SUS to municipal governments, with technical and financial cooperation from the [[federal government|federal]] [[government]] and [[States of Brazil|states]]. Another regionalization initiative is the creation of health consortia, which pools the resources of several neighbouring municipalities. A vital instrument of support for regionalization is the project for strengthening and reorganizing the SUS.

===Regulatory actions===
Procedures for the registration, control, and labelling of foods are established under federal legislation, which assigns specific responsibilities to the health and [[agriculture]] sectors. In the health sector, health inspection activities have been decentralized to the state and municipal governments. The environmental policy derives from specific legislation and from the Constitution of 1988.

The Program for Investment in the Health Industrial Complex (PROCIS) is an example of the [[Medical–industrial complex|medical-industrial complex]] in Brazil.<ref>Viana, Ana Luiza; Pacifico da Silva, Hudson; Ibañez, Nelson; Iozzi, Fabíola. "Development policy for the Brazilian health industry and qualification of national public laboratories". ''Cad. Saúde Pública'': S1–S14. [[Doi (identifier)|doi]]:10.1590/0102-311X00188814</ref> This promotes medical research, development and treatment within Brazil.<ref>"Programa para o Desenvolvimento do Complexo Industrial da Saúde (PROCIS)". ''Ministério da Saúde'' (in Brazilian Portuguese). Retrieved 2022-11-05.</ref> 

===Public healthcare services===
The main strategy for strengthening primary healthcare is the [[Family]] [[Health]] Program, introduced by the municipal health secretariats in collaboration with the states and the Ministry of [[Public health|Public Health]]. The federal government supplies technical support and transfers funding through Piso de Atenção Básica. Disease prevention and control activities follow guidelines established by technical experts in the Ministry of Public Health. The National [[Epidemiology]] Center (CENEPI), an agency of the National [[Health]] Foundation (FUNASA) coordinates the national epidemiological surveillance system, which provides information about and analysis of the national health situation.

===Individual healthcare services===
In 2014 there were 6,706 hospitals in Brazil.  Over 50% of hospitals are found in 5 states: São Paulo, Minas Gerais, Bahia, Rio de Janeiro and Paraná.

Throughout the country, 78% of hospitals practice general medicine while 16% are specialized and 6% provide outpatient care only.<ref>Global Health Intelligence, [http://www.globalhealthintelligence.com "Global Health Intelligence"] ((Webarchive|url=https://web.archive.org/web/20170127151046/http://globalhealthintelligence.com/ |date=2017-01-27 )). Retrieved 16 January 2015.</ref>

In 2012, 66% of the country's hospitals, 70% of its 485,000 hospital beds, and 87% of its 723 specialized hospitals belonged to the private sector. In the area of diagnostic support and therapy, 95% of the 7,318 establishments were also private. 73% of the 41,000 ambulatory care facilities were operated by the public.<ref>Ministry of Health; Registry of healthcare facilities and their installations, [http://www2.datasus.gov.br/DATASUS/index.php?area=0204 "Ministry of Health; Registry of healthcare facilities and their installations"]. Retrieved 7 January 2014.</ref>

The public hospital infrastructure required hospitals to be spread over a territory of ((convert|8.516|e6km2|abbr=off)). As such, the public hospital infrastructure relies on a vast network of small hospitals. Over 55% of public hospitals have less than 50 beds.

Hospital beds in the public sector were distributed as follows: [[surgery]] (21%), clinical [[medicine]] (30%), [[pediatric]]s (17%), [[obstetric]]s (14%), [[psychiatry]] (11%) and other areas (7%). In the same year, 43% of public hospital beds, and half the hospital admissions were in municipal establishments.

Since 1999, the Ministry of Public Health has been carrying out a health surveillance project in Amazonia that includes epidemiological and environmental health surveillance, indigenous health and disease control components. With US 600 million dollars from a [[World Bank]] loan, efforts are being made to improve the operational infrastructure, training of human resources and research studies. An estimated 25% of the population is covered by at least one form of health insurance; 75% of the insurance plans are offered by commercial operators and companies with self-managed plans.

===Health supplies===
Brazil is among the greatest consumers markets for drugs, accounting for 3.5% share of the world market. To expand the access of the population to drugs, incentives have been offered for marketing [[generic product]]s, which cost an average of 40% less than brand-name products. In 2000, there were 14 industries authorized to produce generic drugs and about 200 registered generic drugs were being produced in 601 different forms. In 1998, the National Drug Policy was approved, whose purpose is to ensure safety, efficacy, and quality of drugs, as well as the promotion of rational use and access for the population to essential products. The responsibility for national production of immunobiologicals is entrusted to public laboratories; which have a long-standing tradition of producing vaccines and are for use in official programs. The Ministry of Public Health invested some US$120 million in the development of the capacity of these [[laboratories]]. In 2000, the supply of products was sufficient to meet the need for heterologous use, such as those used in the vaccines against tuberculosis, measles, diphtheria, tetanus, whooping cough, yellow fever, and rabies. In 1999, quality control of the transfused blood consisted of 26 coordinating centers and by 44 regional centers.

===Human resources===
In 1999, the country had some 237,000 [[physician]]s, 145,000 [[dentist]]s, 77,000 [[nurse]]s, 26,000 [[dietitian]]s and 56,000 [[veterinarian]]s. The national average ratio was of 14 physicians per 10,000 population. In 1999, of the 665,000 professional positions, 65% were occupied by physicians, followed by nurses (11%), dentists (8%), pharmacists, biochemists (3.2%), physical therapists (2.8%) and by other professionals (10%).((Citation needed|date=May 2014)) An estimated 1.4 million health sector jobs are occupied by technical and auxiliary personnel. ((Citation needed|date=May 2014))

In 2009, for the first time, more new medical licenses were given for women than for men.<ref name="demografiamedica">Demografia médica no Brasil: Volume 1 (Medical demography in Brazil: volume 1) http://portal.cfm.org.br/images/stories/pdf/demografiamedicanobrasil.pdf (in Portuguese)</ref>

As of 2010, the country had 364,757 physicians.<ref name="demografiamedica" /> In 2011, there were 1.95 physicians for each 1000 Brazilians, with higher concentrations in south, southeast and mid-western than in north and northeastern  Brazil.<ref name="demografiamedica" /> For each 1000 private [[health insurance]] users there were 7.6 occupied work posts for [[physicians]], and for each 1000 [[Sistema Único de Saúde]] users, there were 1.95 occupied work posts for physicians, making an average of 3.33 occupied work posts for physicians for each 1000 Brazilians.<ref name="demografiamedica" /> As to the distribution of physicians between [[Specialty (medicine)|medical specialties]] and [[primary care]], 55.09% of all Brazilian physicians were specialists.<ref name="demografiamedica" />

===Health sector expenditure===
In 1998 national health expenditure amounted to US$62,000 million, which corresponded to nearly 7.9% of [[GDP]]. Of that total, public spending accounted for 41.2% and private expenditure accounted for 58.8%. In [[per capita]] terms, public spending is estimated at US$158 and private expenditure at US$225.

===Technical cooperation===
Technical [[cooperation]] [[project]]s are carried out with different countries, as well as with the World Bank and [[UNESCO]] among many others. International foundations also provide direct financing for projects or individuals. [[Brazil]] is also engaged in an intense exchange with the [[Mercosul]] countries, aimed at establishing common health regulations.<ref>[http://www.paho.org/English/DD/AIS/cp_076.htm About Health in Brazil]</ref>

==Emergency medicine==
[[File:Motolâncias SAMU Distrito Federal.jpg|thumb|right|SAMU Motorbike, [[Federal District (Brazil)|Federal District]]]]

[[Image:Equipe de Neurocirurgia no hospital da Beneficência Portuguesa de Porto Alegre.jpg|thumb|right|[[Surgery]] in [[Porto Alegre]]]]

Brazilian emergency medical service is locally called SAMU ("Serviço de Atendimento Móvel de Urgência (Mobile Emergency Attendance Service)").<ref>Portal da saúde website, [http://portal.saude.gov.br/saude/area.cfm?id_area=456 "SAMU"] ((Webarchive|url=https://web.archive.org/web/20120308095913/http://portal.saude.gov.br/saude/area.cfm?id_area=456 |date=2012-03-08 )). Retrieved 28 April 2009.</ref> [[Emergency medicine]] (EM) is not a new field in Brazil. In 2002, the Ministry of Health outlined a document, the "Portaria 2048," which called upon the entire [[health care system]] to improve [[emergency]] care in order to address the increasing number of victims of [[road]] traffic accidents and violence, as well as the overcrowding of emergency departments (EDs) resulting from an overwhelmed primary care infrastructure. The document delineates standards of care for staffing, [[Medical equipment|equipment]], [[medication]]s and [[medical services|service]]s appropriate for both pre-hospital and in-hospital. It further explicitly describes the areas of knowledge that an emergency provider should master in order to adequately provide care. However, these recommendations have no enforcement mechanism and, as a result, emergency services in Brazil still lack a consistent standard of care.

Pre-hospital emergency medical services use a combination of basic ambulances staffed by technicians and advanced units with physicians on board. No universal phone number exists for emergency calls, and the dispatch center physician determines whether the call merits an emergency transport or not. Pre-hospital [[physician]]s have variable training in emergency care, with training backgrounds ranging from [[internal medicine]] to [[obstetric]]s to surgery.

Similar to the early years of EM in the United States, emergency department physicians in Brazil come from different specialty backgrounds, many of them having taken the job as a form of supplementary income or as a result of unsuccessful private clinical practice. Since 50% of [[medical school]] [[Alumnus|graduates]] in Brazil do not get residency positions, these new physicians with minimal clinical training look for work in emergency departments. In larger tertiary hospitals, the ED is divided into the main specialty areas, internal medicine, surgery, [[psychiatry]], [[pediatric]]s, and staffed by the corresponding [[physician]]s. Still, significant delays in care can occur when patients are inappropriately triaged or when communication between the areas is inadequate.  In the non-tertiary care centers, which make up the majority of hospitals in the country, emergency department physicians are largely under-trained, underpaid and overstressed by their working conditions. This has compromised [[patient]] care and created an incredible need for improvement in the emergency care system.<ref>[http://www.medscape.com/viewarticle/586565 Emergency medicine in Brazil]</ref>

A current plan in action in Brazil called the CATCH plan (Commission for the Advancement of Technology for Communications and Health).  Funding is provided by the [[WHO]], [[ITU]], and voluntary countries and benefactors for existing and future projects.  This CATCH program approbates the best advancements to accommodate Brazil's health issues.

==See also==
* [[Health in Brazil]]
* [[Sistema Único de Saúde]]

==References==
((Reflist))

((EMSworld))
((Brazil topics))
((South America topic|Healthcare in|countries_only=yes))
((Authority control))

[[Category:Healthcare in Brazil]]

Pages transcluded onto the current version of this page (help):

Brazil (view source) (semi-protected)
Economy of Brazil (edit)
Geography of Brazil (edit)
Healthcare in Brazil (edit)
History of Brazil (edit)
Index of Brazil-related articles (edit)
Outline of Brazil (edit)
Politics of Brazil (view source) (semi-protected)
Template:Ambox (view source) (template editor protected)
Template:Authority control (view source) (template editor protected)
Template:Brazil topics (view source) (semi-protected)
Template:Bulleted list (view source) (template editor protected)
Template:Category handler (view source) (protected)
Template:Citation (view source) (protected)
Template:Citation needed (view source) (protected)
Template:Convert (view source) (template editor protected)
Template:Country topics (view source) (template editor protected)
Template:Delink (view source) (protected)
Template:EMS around the world (edit)
Template:EMSworld (edit)
Template:Find sources mainspace (view source) (template editor protected)
Template:Fix (view source) (protected)
Template:Fix/category (view source) (protected)
Template:Hlist/styles.css (view source) (protected)
Template:If empty (view source) (protected)
Template:Lang-pt (view source) (template editor protected)
Template:Main other (view source) (protected)
Template:More citations needed (view source) (template editor protected)
Template:Navbox (view source) (template editor protected)
Template:Nobold (view source) (template editor protected)
Template:Nobold/styles.css (view source) (template editor protected)
Template:Pagetype (view source) (protected)
Template:Reflist (view source) (protected)
Template:Reflist/styles.css (view source) (protected)
Template:SDcat (view source) (protected)
Template:Short description (view source) (protected)
Template:Short description/lowercasecheck (view source) (protected)
Template:Small (view source) (protected)
Template:South America topic (view source) (template editor protected)
Template:Template other (view source) (protected)
Template:Webarchive (view source) (template editor protected)
Template:Yesno (view source) (protected)
Template:Yesno-no (view source) (template editor protected)
Portal:Brazil (edit)
Module:Arguments (view source) (protected)
Module:Authority control (view source) (template editor protected)
Module:Authority control/config (view source) (template editor protected)
Module:Category handler (view source) (protected)
Module:Category handler/blacklist (view source) (protected)
Module:Category handler/config (view source) (protected)
Module:Category handler/data (view source) (protected)
Module:Category handler/shared (view source) (protected)
Module:Check for unknown parameters (view source) (protected)
Module:Citation/CS1 (view source) (protected)
Module:Citation/CS1/COinS (view source) (protected)
Module:Citation/CS1/Configuration (view source) (protected)
Module:Citation/CS1/Date validation (view source) (protected)
Module:Citation/CS1/Identifiers (view source) (protected)
Module:Citation/CS1/Utilities (view source) (protected)
Module:Citation/CS1/Whitelist (view source) (protected)
Module:Citation/CS1/styles.css (view source) (protected)
Module:Convert (view source) (template editor protected)
Module:Convert/data (view source) (template editor protected)
Module:Convert/text (view source) (template editor protected)
Module:Delink (view source) (protected)
Module:Disambiguation/templates (view source) (protected)
Module:EditAtWikidata (view source) (protected)
Module:Find sources (view source) (template editor protected)
Module:Find sources/config (view source) (template editor protected)
Module:Find sources/links (view source) (template editor protected)
Module:Find sources/templates/Find sources mainspace (view source) (template editor protected)
Module:If empty (view source) (protected)
Module:Lang (view source) (template editor protected)
Module:Lang/ISO 639 synonyms (view source) (template editor protected)
Module:Lang/data (view source) (template editor protected)
Module:Language/data/iana languages (view source) (template editor protected)
Module:Language/data/iana regions (view source) (template editor protected)
Module:Language/data/iana scripts (view source) (template editor protected)
Module:Language/data/iana suppressed scripts (view source) (template editor protected)
Module:Language/data/iana variants (view source) (template editor protected)
Module:List (view source) (protected)
Module:Message box (view source) (protected)
Module:Message box/ambox.css (view source) (protected)
Module:Message box/configuration (view source) (protected)
Module:Namespace detect/config (view source) (protected)
Module:Namespace detect/data (view source) (protected)
Module:Navbar (view source) (protected)
Module:Navbar/configuration (view source) (protected)
Module:Navbar/styles.css (view source) (protected)
Module:Navbox (view source) (template editor protected)
Module:Navbox/configuration (view source) (template editor protected)
Module:Navbox/styles.css (view source) (template editor protected)
Module:Pagetype (view source) (protected)
Module:Pagetype/config (view source) (protected)
Module:Pagetype/disambiguation (view source) (protected)
Module:Pagetype/setindex (view source) (protected)
Module:Pagetype/softredirect (view source) (protected)
Module:Redirect (view source) (protected)
Module:SDcat (view source) (protected)
Module:String (view source) (protected)
Module:TableTools (view source) (protected)
Module:Unicode data (view source) (template editor protected)
Module:Unsubst (view source) (protected)
Module:Webarchive (view source) (template editor protected)
Module:Webarchive/data (view source) (template editor protected)
Module:Wikitext Parsing (view source) (protected)
Module:Yesno (view source) (protected)

Return to Healthcare in Brazil.

Retrieved from "https://en.wikipedia.org/wiki/Healthcare_in_Brazil"