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IZA Discussion Paper No. 12111
January 2019
Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil

We investigate universalization of access to health in Brazil. We find large reductions in maternal, foetal, neonatal and post-neonatal mortality, a reduction in fertility and, possibly on account of selection, no change in the quality of births. Using rich administrative data, we investigate changes in organization, access and outcomes, thereby illuminating the driving mechanisms. We find sharp increases in coverage of primary health facilities with GPs and outreach workers and, in line with this, increases in outpatient procedures, prenatal care visits, health-education activities and home visits by medical professionals. Consistent with an attempt to rationalize use of hospital resources, we find a decline in specialists and hospital beds per capita. Despite this, we see increases in hospital births, C-sections, and maternal hospitalization for complications, with no change in rates of infant hospitalization.

Communications
Mark Fallak
mark.fallak@liser.lu
+352 585-855-526
World of Labour
Olga Nottmeyer
olga.nottmeyer@liser.lu
+352 585-855-501
Network Coordination
Christina Gathmann
christina.gathmann@liser.lu

The IZA@LISER Network is a global community of scholars dedicated to excellence in labor economics and related fields, now coordinated at the Luxembourg Institute of Socio-Economic Research (LISER) following its transition from Bonn.

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