Estruturas de financiamento e gasto do sistema público de saúde

Piola, Sérgio Francisco; Servo, Luciana Mendes Santos; Sá, Edvaldo Batista de; Paiva, Andrea Barreto de

doi:10.7476/9788581100180.0003

Cited by 14 publications

(21 citation statements)

References 6 publications

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“…The public health expenditure share of the GDP in all levels of government – federal, state and municipal - increased from 2.9 to 3.9 % between 2000 and 2011 [27]. Despite these advances, the public health expenditure in Brazil is still much lower compared to other countries with universal health systems [28].…”

Section: Discussionmentioning

confidence: 99%

Coverage and equity in reproductive and maternal health interventions in Brazil: impressive progress following the implementation of the Unified Health System

França

Restrepo‐Méndez

Maia

et al. 2016

Int J Equity Health

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BackgroundThe Brazilian SUS (Unified Health System) was created in 1988 within the new constitution, based on the premises of being universal, comprehensive, and equitable. The SUS offers free health care, independent of contribution or affiliation. Since then, great efforts and increasing investments have been made for the system to achieve its goals. We assessed how coverage and equity in selected reproductive and maternal interventions progressed in Brazil from 1986 to 2013.MethodsWe reanalysed data from four national health surveys carried out in Brazil in 1986, 1996, 2006 and 2013. We estimated coverage for six interventions [use of modern contraceptives; antenatal care (ANC) 1+ visits by any provider; ANC 4+ visits by any provider; first ANC visit during the first trimester of pregnancy; institutional delivery; and Caesarean sections] using standard international definitions, and stratified results by wealth quintile, urban or rural residence and country regions. We also calculated two inequality indicators: the slope index of inequality (SII) and the concentration index (CIX).ResultsAll indicators showed steady increases in coverage over time. ANC 1+ and 4+ and institutional delivery reached coverage above 90 % in 2013. Prevalence of use of modern contraceptives was 83 % in 2013, indicating nearly universal satisfaction of need for contraception. On a less positive note, the proportion of C-sections has also grown continuously, reaching 55 % in 2013. There were marked reductions in wealth inequalities for all preventive interventions. Inequalities were significantly reduced for all indicators except for the C-section rate (p = 0.06), particularly in absolute terms (SII).ConclusionsDespite the difficulties faced in the implementation of SUS, coverage of essential interventions increased and equity has improved dramatically, due in most cases to marked increase in coverage among the poorest 40 %. An increase in unnecessary Caesarean sections was also observed during the period. Further evaluation on the quality of healthcare provided is needed.

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Section: Discussionmentioning

confidence: 99%

Coverage and equity in reproductive and maternal health interventions in Brazil: impressive progress following the implementation of the Unified Health System

França

Restrepo‐Méndez

Maia

et al. 2016

Int J Equity Health

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show abstract

“…Since the enactment of the 1988 Federal Constitution, Brazil has expanded the decentralization of health services and initiatives to subnational entities, giving states and municipalities greater autonomy (12). This is also reflected in the country's public health funding; in 2000, the Federal Government was responsible for 59.8% of the total public health expenditure, declining to 44.7% by 2011 (33). Nevertheless, decentralization has not overcome the physician shortage in vulnerable, remote areas.…”

Section: Discussionmentioning

confidence: 99%

Cost of providing doctors in remote and vulnerable areas: Programa Mais Médicos in Brazil

Silva

Ramos

Santos

et al. 2018

Rev Panam Salud Publica

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Objective To evaluate the Programa Mais Médicos (More Doctors Program; PMM) in Brazil by estimating the proportional increase in the number of doctors in participating municipalities and the program costs, stratified by cost component and funding source. Methods Official data from the 2013 edition of Demografia Médica no Brasil (Medical Demography in Brazil) was used to estimate the number of doctors prior to PMM. The number of doctors at the end of the fourth PMM recruiting cycle (July 2014) was obtained from the Ministry of Health. Cost components were identified and estimated based on PMM legislation and guidelines. The participating municipalities were chosen based on four criteria, all related to vulnerability. Results The PMM provided an additional 14 462 physicians to highly vulnerable, remote areas in 3 785 municipalities (68% of the total) and 34 Special Indigenous Sanitary Districts. There was a greater increase of physicians in the poorest regions (North and Northeast). The estimated annual cost of US$ 1.1 billion covered medical provision, continuing education, and supervision/mentoring. Funding was largely centralized at the federal level (92.6%). Conclusion The cost of PMM is considered relatively moderate in comparison to its potential benefits for population health. The greater increase of doctors for the poorest and most vulnerable met the target of correcting imbalances in health worker distribution. The PMM experience in Brazil can contribute to the debate on reducing physician shortages.

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“…Segundo dados do Instituto Brasileiro de Geografia e Estatística (IBGE, 2017) as despesas com saúde representam 8,2% do Produto Interno Bruto (PIB), gasto equiparado ao dos países subdesenvolvidos e expressivos quando não se considera que o sistema de saúde deve garantir cobertura universal e atendimento integral. Para Piola et al (2013), o óbice reside justamente em financiar um sistema assistencialista e íntegro diante de limitações estruturais. Na tentativa de sanar a dificuldade adotaram-se incentivos governamentais ao mercado privado, que, em excesso, ultrapassou o gasto público.…”

Section: Desafios Do Sus E Despesas Com Saúde No Brasilunclassified

Gastos Do Sistema Público De Saúde Com Tratamento Em Oncologia

Gomes

Nascimento²,

Sousa³

et al. 2021

RAHIS

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Objetivo: Identificar e estruturar as despesas do sistema público de saúde com tratamento em oncologia e discutir a respeito dos resultados encontrados em relação aos gastos praticados em outros países. Método: Trata-se de uma pesquisa longitudinal retrospectiva, entre 2008 e 2020. Realizou-se uma análise dos custos de produção ambulatorial do SUS (DATASUS – SAI). Classificou-se os gastos conforme os tipos de tratamento, estas variáveis geraram estatísticas descritivas; calculou-se, também, uma estimativa do valor médio por sessão de tratamento. Resultados: Verificou-se um aumento crescente, de 2008 a 2020 nos procedimentos clínicos pelo SUS, entre os quais, os gastos com oncologia representavam a segunda maior alocação. Dos gastos totais, os procedimentos de Quimioterapia paliativa – adulto detém maior volume, por outro lado, os menores desembolsos são alocados nos procedimentos de medicina nuclear – terapêutica oncológica. Conclusão: Em relação a países desenvolvidos o Brasil ainda se apresenta tímido quanto a destinação de recursos à saúde, sobretudo aos procedimentos com tratamento em oncologia.

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Estruturas de financiamento e gasto do sistema público de saúde

Cited by 14 publications

References 6 publications

Coverage and equity in reproductive and maternal health interventions in Brazil: impressive progress following the implementation of the Unified Health System

Coverage and equity in reproductive and maternal health interventions in Brazil: impressive progress following the implementation of the Unified Health System

Cost of providing doctors in remote and vulnerable areas: Programa Mais Médicos in Brazil

Gastos Do Sistema Público De Saúde Com Tratamento Em Oncologia

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