Worldwide Physical Therapy Practice - Brazil

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Patient Access to Physiotherapy or Physical Therapy Services / Entry Point

Brazilians can access physical therapy services through the public health system, health insurance and private clinics. The public health system in Brazil is called Sistema Único de Saude (Unified Health System) better known by the acronym SUS. Patients treated by SUS will need a referral from a primary care physician to access physical therapy treatment. The entire treatment is performed at a clinic affiliated to SUS.[1] Brazilian citizens covered by a private health insurance will also need a referral from a physician, however, they are free to choose any physical therapy facility in the insurance network. Patients in Brazil can also seek physical therapy treatment in private physical therapy clinics without the need of a physician referral.

Therapist Preparation

Degree/Credentialing

To become a physiotherapist in Brazil, an undegrad degree is required. A 5-year study program will prepare the prospective professional in the following areas:

  • Trauma and Orthopeadic;
  • Sport;
  • Neurology;
  • Paediatric;
  • Cardiovascular;
  • Respiratory;
  • Urogynecology and Obstetric;
  • Public health;
  • Dermatology;

By law, the program must offer 4.500 hours of study being, at least 800 in practical internship. After completing the program the student is awarded the title of Bachelor in Physical Therapy.[2]

There are 503 physical therapy programs in Brazil (57 publics).

Specialization

The specialization programs accredited by COFFITO (Federal Board of Physical Therapy and Occupational Therapy are:

  • Acupuncture:
  • Aquatic therapy;
  • Cardiovascular Physiotherapy;
  • Dermatofunctional Physiotherapy;
  • Sports Physiotherapy;
  • Ergonomics;
  • Neurofunctional Physiotherapy;
  • Physiotherapy in Oncology;
  • Respiratory Physiotherapy;
  • Trauma and Orthopaedic Physiotherapy;
  • Osteopathy;
  • Chiropractic;
  • Women's Health Physiotherapy;
  • Intensive Physiotherapy.

Professional Associations

  • Federal Board of Physiotherapy and Occupational Therapy - Conselho Federal de Fisioterapia e Terapia Ocupacional – COFFITO: it is a Federal organization founded in 1997. The overall mission of COFFITO is to standardize and execute the etic, scientific and social control of the physical therapy and occupational therapy professions.[3]
  • Each state has its own physical therapy board. Physical therapists must be registered in their board jurisprudence called CREFITO (Conselho Regional de Fisioterapia e Terapia Ocupacioal) in order to be issued a Physiotherapist license.

Information about the Patient Community

The total population of Brazil is 206,848,399.[4] In the latest World Health Organization data published in 2015 life expectancy in Brazil is: Male 71.4, Female 78.7 and total life expectancy is 75.0 which gives Brazil a World Life Expectancy ranking of 65. The proportion of children below the age of 15 in 2015 was 25.0%, 69.2% was between 15 and 65 years of age, while 7.8% was 65 years or older.3
The 10 most common causes of death are: ischemic heart disease (10.5%), stroke (9.3%), lower respiratory infection (6.1%), diabetes (5.6%), interpersonal Violence (4.8%), Hypersensitive heart disease (4.7%), road injury (3.7%), COPD (3.4%), Trachea, bronchus and lung cancer (2,1%), cirrhosis of the liver (1.8%).[5]

Social/Cultural Influences

Brazilian society is made up of a confluence of people from several countries, from the original Native Brazilians, with the influx of Portuguese colonizers, Black African slaves, European, Arab, and Japanese immigration. Other significant groups include Koreans, Chinese, Paraguayans, and Bolivians. The Brazilian family composition still follows the nuclear model (father, mother and children), however this structure has been losing space in the Brazilian society. Nowadays, Brazilian families are also compound by single parents and same sex couples. Regarding healthcare, the Brazilian family plays an important role as the primary caregiver. Usually the family takes all the responsibility for the patient care. [6]

Delivery of Care

In 1988, Brazilian federal government founded the Unified Health System (SUS), a publicly funded health entirely free of any cost, for any person, including foreigners. The Brazilian public health system treats annually 180 million of people and perform around 2.8 billion of primary care procedures and high complexity medical care. There are 313.498 public hospital beds in Brazil, with a high concentration in the south/southeast region of the country. Although these number seems impressive, the public health system in Brazil is far from being an ideal model of health system. The public hospitals lack good administrations and the resources are not enough to keep the installations and maintenance of medical equipment in perfect conditions. There is a huge waiting list for high complexity surgeries and image diagnoses.[7]

Type of Health System

Public HealthCare is provided by the Unified Health System and funded with resources from the Federal, State and Municipal Government. People have access to public hospital, image diagnostic centers, laboratory exams centers and rehabilitation institutions.Private health insurance are provided for employed citizens and people who can afford paying for their own private insurance. The healthcare is delivered through private physicians and hospitals affiliated with insurance companies.

Payment System

Payment for healthcare in Brazil, including physical therapy is funded by the government when health public system is used. Insurance companies provide payment for health treatment through their network affiliates.


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References

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  1. http://portalsaude.saude.gov.br
  2. http://coffito.gov.br/nsite/?p=1206
  3. Cite error: Invalid <ref> tag; no text was provided for refs named coffito
  4. http://www.ibge.gov.br/home/
  5. http://www.who.int/gho/countries/bra.pdf?ua=1
  6. http://www.pragmatismopolitico.com.br/wp-content/uploads/2016/10/ribeiro_darcy_povo_brasileiro_formacao_e_o_sentido_do_brasil.pdf
  7. http://portalsaude.saude.gov.br/index.php/cidadao/entenda-o-sus/leia-mais-mesa-de-negociacao-do-sus-entenda-o-sus?start=10



===  ===

The specialization programs accredited by COFFITO (Federal Board of Physical Therapy and Occupational Therapy are:

  • Acupuncture:
  • Aquatic therapy;
  • Cardiovascular Physiotherapy;
  • Dermatofunctional Physiotherapy;
  • Sports Physiotherapy;
  • Ergonomics;
  • Neurofunctional Physiotherapy;
  • Physiotherapy in Oncology;
  • Respiratory Physiotherapy;
  • Trauma and Orthopaedic Physiotherapy;
  • Osteopathy;
  • Chiropractic;
  • Women's Health Physiotherapy;
  • Intensive Physiotherapy.

Professional Associations

  • Federal Board of Physiotherapy and Occupational Therapy - Conselho Federal de Fisioterapia e Terapia Ocupacional – COFFITO: it is a Federal organization founded in 1997. The overall mission of COFFITO is to standardize and execute the etic, scientific and social control of the physical therapy and occupational therapy professions.[1]
  • Each state has its own physical therapy board. Physical therapists must be registered in their board jurisprudence called CREFITO (Conselho Regional de Fisioterapia e Terapia Ocupacioal) in order to be issued a Physiotherapist license.

Information about the Patient Community

The total population of Brazil is 206,848,399.[2] In the latest World Health Organization data published in 2015 life expectancy in Brazil is: Male 71.4, Female 78.7 and total life expectancy is 75.0 which gives Brazil a World Life Expectancy ranking of 65. The proportion of children below the age of 15 in 2015 was 25.0%, 69.2% was between 15 and 65 years of age, while 7.8% was 65 years or older.3
The 10 most common causes of death are: ischemic heart disease (10.5%), stroke (9.3%), lower respiratory infection (6.1%), diabetes (5.6%), interpersonal Violence (4.8%), Hypersensitive heart disease (4.7%), road injury (3.7%), COPD (3.4%), Trachea, bronchus and lung cancer (2,1%), cirrhosis of the liver (1.8%).[3]


Social/Cultural Influences

Brazilian society is made up of a confluence of people from several countries, from the original Native Brazilians, with the influx of Portuguese colonizers, Black African slaves, European, Arab, and Japanese immigration. Other significant groups include Koreans, Chinese, Paraguayans, and Bolivians. The Brazilian family composition still follows the nuclear model (father, mother and children), however this structure has been losing space in the Brazilian society. Nowadays, Brazilian families are also compound by single parents and same sex couples. Regarding healthcare, the Brazilian family plays an important role as the primary caregiver. Usually the family takes all the responsibility for the patient care. [4]

Delivery of Care

In 1988, Brazilian federal government founded the Unified Health System (SUS), a publicly funded health entirely free of any cost, for any person, including foreigners. The Brazilian public health system treats annually 180 million of people and perform around 2.8 billion of primary care procedures and high complexity medical care. There are 313.498 public hospital beds in Brazil, with a high concentration in the south/southeast region of the country. Although these number seems impressive, the public health system in Brazil is far from being an ideal model of health system. The public hospitals lack good administrations and the resources are not enough to keep the installations and maintenance of medical equipment in perfect conditions. There is a huge waiting list for high complexity surgeries and image diagnoses.[5]

Type of Health System

Public HealthCare is provided by the Unified Health System and funded with resources from the Federal, State and Municipal Government. People have access to public hospital, image diagnostic centers, laboratory exams centers and rehabilitation institutions.Private health insurance are provided for employed citizens and people who can afford paying for their own private insurance. The healthcare is delivered through private physicians and hospitals affiliated with insurance companies.

Payment System

Payment for healthcare in Brazil, including physical therapy is funded by the government when health public system is used. Insurance companies provide payment for health treatment through their network affiliates.
  1. http://coffito.gov.br/nsite/?page_id=2344
  2. Cite error: Invalid <ref> tag; no text was provided for refs named ibge
  3. Cite error: Invalid <ref> tag; no text was provided for refs named who
  4. Cite error: Invalid <ref> tag; no text was provided for refs named darcy
  5. Cite error: Invalid <ref> tag; no text was provided for refs named sus