Resumo / Descrição

Background Limited evidence exists on impacts and adaptations of global health markets during COVID-19. We examined physicians’ perceptions of changing employment opportunities in Brazil, to gain an insight into labour markets in low- and middle-income countries (LMICs) during the pandemic.

Methods We conducted secondary analysis of a dataset from a representative cross-sectional survey of 1,183 physicians in São Paulo and Maranhão states in Brazil. We estimated prevalence and 95% Confidence Intervals (CI) for proxy variables of demand and supply of doctors, and prices of medical services for facilities of practice in the two States, stratified by public, private, and dual practice physicians.

Results Most doctors reported increased job opportunities in the public sector (59.0%, 95% CI 56.1-61.9), particularly in Maranhão state (66.4%, 95% CI 62.3-70.3). For the private sector, increased opportunities were reported only in large private hospitals (51.4%, 95% CI 48.4-54.4), but not in smaller clinics. We recorded perceptions of slight increases in availability of doctors in Maranhão, particularly in the public sector (54.1%, 95 CI 45.7-62.3). Younger doctors recounted increased vacancies in the public sector (64%, 95 CI 58.1-68.1); older doctors only in walk-in clinics in Maranhão (47.5%, 95 CI 39.9-55.1). Those working directly with COVID-19 saw opportunities in public hospitals (65%, 95 CI 62.3-68.4), and in large private ones (55%, 95 CI 51.8-59.1)

Conclusions Our findings suggest that health labour markets in (LMICs) may not necessarily shrink during epidemics, and that impacts will depend on the balance of public and private services in national health systems.