Analysis of the implementation of the Federal Incentive for Physical Activity in Primary Care: equity in focus

Abstract

The objectives of this study were to present a national overview of the first year of implementation of the Financial Incentive for Physical Activity in Primary Health Care (PHC) of the Unified Health System (SUS) and to analyze whether the municipal prioritization score was an effective criterion for greater equity in the distribution of resources. This is an ecological study with analyses of the number of municipalities and health units approved for the Physical Activity Incentive in PHC and the amounts paid between May 2022 and September 2023. To assess equity, measures of absolute and relative inequalities were calculated between health units, grouped into quartiles according to the municipal prioritization score. The percentage of health units funded did not exceed 37.6%, and the establishment of goals reduced the number of health units that received resources from the Physical Activity Incentive in PHC by 68.9% and the amount of resources paid by 44.0%. Significant inequalities were observed in the allocation of resources, with a higher percentage of health units located in municipalities with lower priority. Thus, the criteria adopted were insufficient to ensure equity in the distribution of resources.