Specialized health care in Brazil has been provided by the private sector under public regulation and financing since the 1950s. It continued after the promulgation of the 1988 Federal Constitution, which also created the Unified Health System (SUS). In the last decades, the share of the private sector has increased in tertiary care, including cardiovascular services, generating changes in SUS. This study analyzes the public-private relationship in the National Tertiary Care Policy for Cardiovascular Conditions from 2008 to 2014. The results indicate that, compared to the public sector, the private sector has a greater share in both tertiary care for cardiovascular conditions and receivables for providing health services. This points to a contradiction in the management of the health system in Brazil, which, albeit public, all-population-oriented, and free in its conception, has privileged the private sector.
Specialized health care in Brazil has been provided by the private sector under public regulation and financing since the 1950s. It continued after the promulgation of the 1988 Federal Constitution, which also created the Unified Health System (SUS). In the last decades, the share of the private sector has increased in tertiary care, including cardiovascular services, generating changes in SUS. This study analyzes the public-private relationship in the National Tertiary Care Policy for Cardiovascular Conditions from 2008 to 2014. The results indicate that, compared to the public sector, the private sector has a greater share in both tertiary care for cardiovascular conditions and receivables for providing health services. This points to a contradiction in the management of the health system in Brazil, which, albeit public, all-population-oriented, and free in its conception, has privileged the private sector.
As doenças crônicas não transmissíveis (DCNTs) cardiovasculares são a maior causa de mortalidade no Brasil, além de ter maior custo para o Sistema Único de Saúde (SUS). Objetiva-se, nesse contexto, avaliar a relação público-privada no âmbito da Política Nacional de Atenção Cardiovascular (PNACAC) quanto ao acesso regional aos procedimentos de alta complexidade na cardiologia e quanto ao custo desses procedimentos, de 2008 a 2015. Utilizou-se, para tanto, o IDSUS nº 9, adaptado para conter resultados regionais e limitado aos procedimentos contidos na PNACAC. Os resultados mostraram que: (i) as internações em instituições privadas financiadas pelo SUS superaram à quelas ocorridas em hospitais públicos, em todos os anos para todas as Regiões, com exceção da Norte; (ii) é mais caro para o SUS financiar internações em hospitais privados do que em públicos; e, (iii) o IDSUS adaptado da Região Norte indicou que os residentes obtiveram maior acesso a rede SUS (hospitais públicos mais privados) quando comparada com as outras Regiões. Concluiu-se que a relação público-privada, no âmbito da PNACAC, não garantiu, para o período de análise, acesso equitativo aos procedimentos, e que esta parece não ter sido eficiente.
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