Distribution of physiotherapy professionals and services in public health in Goiás: coverage according to socioeconomic variables

Abstract

Introduction: Public health in Brazil goes beyond social production, with an expanded view of health. Its complex structure includes physical therapy. Objective: To characterize physical therapy in Goiás based on the National Registry of Health Facilities (CNES in Portuguese). Methods: Data on specialty, municipality, place of employment, working hours, employment relationship, type of contract and establishment, number of physical therapists, administrative setting, macroregion and health region were tabulated. The following were correlated: municipal population; people dependent on the National Health System (SUS in Portuguese); municipal per capita gross domestic product (GDP); municipal Human Development Index (HDI); percentage of inhabitants dependent on the municipal SUS; number of people covered by municipal physiotherapy (NPCAF). Results: In the CNES, (reference July/2019) in Goiás, we found 2,187 physiotherapists in public/private facilities, in 3,353 workplaces. In establishments that serve the SUS, we identified 1,673 physiotherapists in 2,436 workplaces, 32.9% of which are linked to primary and 67.1% to specialized care. The weekly workload was 38 hours and 26 hours per workplace. Only 30.1% of the municipalities had adequate NPCAF. Health regions and macroregions had inadequate coverage. The NPCAF showed an inverse correlation with GDP (r = -0.20; p < 0.001) and HDI (r = -0.14; p = 0.02) and a direct correlation with the population (r = 0.46; p < 0.001). Conclusion: Goiás has inadequate coverage in 69.9% of the municipalities, in the macroregions and health regions. Expanding the number of workplaces available to physiotherapists is essential to achieve universal and comprehensive health care, reducing inequity and favoring equitable distribution.