Has the Mais Médicos program reached physician desert areas? A spatial analysis from 2013 to 2023

Abstract

This study examines the spatial distribution of physicians in the Programa Mais Médicos (PMM) across Brazilian municipalities from 2013 to 2023. Through Exploratory Spatial Data Analysis (ESDA), with an emphasis on identifying clustering patterns, the findings indicate a continuous increase in physician density until 2017, followed by a sharp decline after the departure of Cuban doctors in 2018. The Moran’s Index analysis identified high high clusters, representing municipalities with a high concentration of physicians surrounded by others in a similar condition, and low-low clusters, indicating areas with a scarcity of professionals adjacent to similarly underserved regions, highlighting regional disparities in healthcare access. The program’s suspension in 2018 exacerbated the shortage of medical professionals in vulnerable areas, whereas its reinstatement in 2023 suggests an effort to address previous shortcomings and expand healthcare access. Thus, the PMM illustrates how institutional changes impact public health policies.