SUS: o que e como fazer?

Campos, Gastão Wagner de Sousa

doi:10.1590/1413-81232018236.05582018

Cited by 49 publications

(61 citation statements)

References 2 publications

(2 reference statements)

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“…[21] SUS receives only 46% of the available funds slated for public health. [30] This has led to an increase in patient cost-sharing (e.g., out-ofpocket expenditures) for persons in the lower economic strata, as well as nearly 400,000 lawsuits related to insu cient health coverage. [50].…”

Section: Discussionmentioning

confidence: 99%

“…Since inception of Plan Nacer, the low birth weight mortality rates have dropped 9%, while neonatal mortality has fallen 22%. [18,19] [18,19] Central government transferred more than USD 234 million to provinces to fund primary health strategy over SUM\AR [19] HIS is still in development and the country lacks of connectivity across the entire health [18] [19] Strong criticisms about underfunding of SUS [30] Federal spending on healthcare unchanged over 15 year period, slight increase of 0,7% GDP in public health expenditure over 5 year period [21] and still under subsidized causing effect inequalities [24] Labor contributions are based on fixed proportion of the income collected by the government under FOSYGA [ Enhancing the primary care network in Argentina, they introduced preventive health programs, such as those addressing sexually transmitted infections, cardiovascular disease, diabetes, and other chronic conditions. It also increased the number of deliveries attended by skilled healthcare workers, especially for those living below the poverty level.…”

Section: Healthcare Service Deliverymentioning

confidence: 99%

“…[46] However, signi cant controversy surrounding the recent introduction of foreign insurance companies and healthcare providers [33] to the market and the indiscriminate, not outcome-based payments for these organizations. [29,30] Brazil has long sought societal representation in policymaking at different levels (federal, state and municipalities) through its health councils. [32] However, the lack of continuity in political will and policies to legitimize citizen involvement have contributed to structural and nancial hurdles.…”

Section: Argentinamentioning

confidence: 99%

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Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

Gilardino¹,

B²,

Valanzasca³

2020

Preprint

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Background: During the 1990s, health systems within several Latin American countries changed to expand service coverage and reach more people. These changes are considered the antecedent of the Universal Health Coverage (UHC). Seven years after the United Nations’ call for UHC, healthcare services in Argentina, Brazil, Colombia, Mexico are generally accessible and affordable. However, these countries increasingly struggle to meet their populations’ growing health needs while also addressing rising health care costs. This research aims to describe measures taken by these four countries to commit by UHC, addressing their barriers and challenges. Methods: This study examined literature review data, supplemented with survey data collected from regional stakeholders. Data were analyzed within an ad-hoc matrix.Results: These four countries increased healthcare services coverage by strengthening their primary healthcare systems. They also expanded coverage for non-communicable diseases, provided community outreach, and increased the number of skilled healthcare workers. New pharmaceutical support programs provided access to treatments for chronic conditions at zero cost, while high-costs drugs and cancer treatments were partially guaranteed. However, these measures did not achieve full financial protection to all, leaving citizens exposed to possible catastrophic expenditures, despite increased service coverage. UHC is funded primarily through taxes and polling resources, and these four countries still struggle to find mechanisms that could increase pooling mechanisms capable of increasing service coverage, while reducing financial inequities among people. Conclusions: Argentina, Brazil, Colombia, and Mexico have made progress towards UHC. Nevertheless, additional mechanisms to sustain financial protection are urgently required. The decentralization of the primary healthcare system, the development of public-private partnerships, and the implementation of progressive financing mechanisms like conditional cash transfers are potential manners to improve service delivery and financial protection contributing to effective UHC.

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Section: Discussionmentioning

confidence: 99%

Section: Healthcare Service Deliverymentioning

confidence: 99%

Section: Argentinamentioning

confidence: 99%

See 1 more Smart Citation

Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

Gilardino¹,

B²,

Valanzasca³

2020

Preprint

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“…The preservation of Brazilian democracy also requires the articulation of the rights-advocacy movements 25 , including homeless people struggling for housing, landless people for agrarian reform and ecological agriculture, indigenous people and their right to the territory and a dignified existence, blacks and the fight against all forms of racism, women seeking equality, the…”

Section: The Current Challenges Of the Struggle For The Right To Healmentioning

confidence: 99%

Os desafios atuais da luta pelo direito universal à saúde no Brasil

Souza

Paim

Teixeira

et al. 2019

Ciênc. saúde coletiva

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Resumo Desde a promulgação da Constituição federal de 1988, o Brasil mudou muito. Na saúde, embora tenham ocorrido avanços importantes, persistem problemas antigos e novos têm surgido. O objetivo maior de assegurar o direito universal à saúde não foi alcançado. Em 2019, realiza-se a 16ª Conferência Nacional de Saúde, momento oportuno para analisar a história, o momento presente e as tendências que se anunciam. Este texto busca contribuir para essa análise, com base nos resultados de estudos sobre a evolução das condições de saúde da população e do sistema de saúde brasileiro nos últimos 30 anos. Identifica o fortalecimento do setor privado e do capital na área da saúde, em detrimento do interesse público e do SUS. Por fim, discute as estratégias de luta pelo direito à saúde necessárias e possíveis no contexto atual.

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“…However, since SUS creation in 1988, the system has been facing numerous difficulties regarding the user access to resolving, appropriate, timely and effective health actions and services. The extent of benefits brought to the population throughout its existence is undeniable, but, in practice, it is still partial, facing numerous weaknesses and shortcomings 20 . SUS has been implemented but not consolidated 21 .…”

Section: Introductionmentioning

confidence: 99%

Absenteísmo de usuários como fator de desperdício: desafio para sustentabilidade em sistema universal de saúde

et al. 2019

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Non-attendance to specialized healthcare appointments, diagnostic, and therapeutic procedures is a global problem in healthcare, leading to the wastage of resources both in the public and private sectors. This study aims to estimate financial wastage of resources linked to non-attendance to scheduled health specialist appointments and procedures in the metropolitan region of the Espírito Santo State (ES), Brazil, between 2014 and 2016. We studied 1.002.719 specialized healthcare procedures, being 666.182 appointments with specialized physicians and other healthcare professionals, and 336.537 specialized diagnostic and other therapeutic procedures. Non-attendance date were retrieved from the administrative procedure scheduling database (SisReg-ES) available in the ES Regulatory Agency and provided by the ES Health Office. Financial values used to estimate wastage were retrieved from the SUS and other standard tariff lists for medical procedures, and used according to the administrative regime of the three types of service providers. Non-attendance average rate for medical and health specialists' appointments achieved 38.6%, or 257.025 missed appointments, equivalent to an estimated waste of resources of R$3.558.837,88. Non-attendance as for other specialized procedures reached 32.1%, or 108.103 missed procedures, equivalent to R$15.007.624,15. Total wasted resources reached significant values, evincing the ongoing challenge to managers seeking to attain SUStainable universal health care systems.KEYWORDS Absenteeism. Secondary care. Health management. Integrality in health. RESUMO O absenteísmo de usuários em consultas e exames é considerado um problema mundial na assistência à saúde, gerando desperdício de recursos tanto no setor público como no setor privado. O objetivo deste estudo foi o de estimar o desperdício de recursos monetários vinculado ao absenteísmo em procedimentos especializados no Sistema Único de Saúde (SUS) naRegião de Saúde Metropolitana do Espírito Santo (RSM-ES) entre os anos de 2014 e 2016. Analisaram-se 1.002.719 procedimentos, sendo 666.182 consultas e 336.537 exames especializados. Os dados de absenteísmo foram retirados dos registros administrativos do Sistema de Regulação do ES (SisReg-ES), fornecidos pela Secretaria Estadual de Saúde. Os valores monetários foram obtidos por meio da Tabela SUS, da tabela complementar de convênios e da tabela de custos estimados, segundo o tipo de prestador envolvido no atendimento. A taxa média de absenteísmo para consultas foi de 38,6% (257.025 consultas), gerando um total estimado de R$3.558.837,88; e para exames especializados, foi de 32,1% (108.103 exames), em um total estimado de R$15.007.624,15. Os valores totais desperdiçados são significativos e evidenciam o desafio constante na agenda dos gestores na busca pela SUStentabilidade em sistemas universais de saúde. PALAVRAS-CHAVE Absenteísmo. Atenção secundária à saúde. Gestão em saúde. Integralidade em saúde.

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SUS: o que e como fazer?

Cited by 49 publications

References 2 publications

Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

Os desafios atuais da luta pelo direito universal à saúde no Brasil

Absenteísmo de usuários como fator de desperdício: desafio para sustentabilidade em sistema universal de saúde

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