Subfinanciamento e orçamento federal do SUS: referências preliminares para a alocação adicional de recursos

Funcia, Francisco Rózsa

doi:10.1590/1413-812320182412.25892019

Cited by 38 publications

(24 citation statements)

References 4 publications

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“…SUS is at the forefront of the response to the pandemic. The system, however, has been historically underfunded and particularly harmed by austerity measures implemented in 2016, when public investments in social areas were frozen for 20 years [19].…”

Section: Covid-19 Health Equity Perspectives: Brazilmentioning

confidence: 99%

Health equity and COVID-19: global perspectives

Shadmi

Chen

Dourado

et al. 2020

Int J Equity Health

499

378

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The COVID-19 is disproportionally affecting the poor, minorities and a broad range of vulnerable populations, due to its inequitable spread in areas of dense population and limited mitigation capacity due to high prevalence of chronic conditions or poor access to high quality public health and medical care. Moreover, the collateral effects of the pandemic due to the global economic downturn, and social isolation and movement restriction measures, are unequally affecting those in the lowest power strata of societies. To address the challenges to health equity and describe some of the approaches taken by governments and local organizations, we have compiled 13 country case studies from various regions around the world: China,

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Section: Covid-19 Health Equity Perspectives: Brazilmentioning

confidence: 99%

Health equity and COVID-19: global perspectives

Shadmi

Chen

Dourado

et al. 2020

Int J Equity Health

499

378

View full text Add to dashboard Cite

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“…Most services were under-resourced with regard to staffing, which affected monitoring implementation. This barrier was also reported in a pilot study [7] and reflects the funding pressures within the public healthcare system in Brazil (SUS), which recently worsened due to constitutional amendments limiting funding [16]. Additionally, during the intervention period, the emergence of the COVID-19 pandemic impacted the organization of HIV services and canceled routine activities, maintaining only emergency care and antiretroviral dispensation within public health services, and some professionals were transferred to other services in the healthcare system [17,18].…”

Section: Plos Onementioning

confidence: 86%

Improving the continuum of care monitoring in Brazilian HIV healthcare services: An implementation science approach

Loch¹,

Rocha²,

Fonsi³

et al. 2021

PLoS ONE

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Objective To evaluate the impact of an intervention improving the continuum of care monitoring (CCM) within HIV public healthcare services in São Paulo, Brazil, and implementing a clinical monitoring system. This system identified three patient groups prioritized for additional care engagement: (1) individuals diagnosed with HIV, but not receiving treatment (the treatment gap group); (2) individuals receiving treatment for >6 months with a detectable viral load (the virologic failure group); and (3) patients lost to follow-up (LTFU). Methods The implementation strategies included three training sessions, covering system logistics, case discussions, and development of maintenance goals. These strategies were conducted within 30 HIV public healthcare services (May 2019 to April 2020). After each training session, professionals shared their experiences with CCM at regional meetings. Before and after the intervention, providers were invited to answer 23 items from the normalization process theory questionnaire (online) to understand contextual factors. The mean item scores were compared using the Mann–Whitney U test. The RE-AIM implementation science framework (evaluating reach, effectiveness, adoption, implementation, and maintenance) was used to evaluate the integration of the CCM. Results In the study, 47 (19.3%) of 243 patients with a treatment gap initiated treatment, 456 (49.1%) of 928 patients with virologic failure achieved suppression, and 700 of 1552 (45.1%) LTFU patients restarted treatment. Strategies for the search and reengagement of patients were developed and shared. Providers recognized the positive effects of CCM on their work and how it modified existing activities (3.7 vs. 4.4, p<0.0001, and 3.9 vs. 4.1, p<0.05); 27 (90%) centers developed plans to sustain routine CCM. Conclusion Implementing CCM helped identify patients requiring more intensive attention. This intervention led to changes in providers’ perceptions of CCM and care and management processes, which increased the number of patients engaged across the care continuum and improved outcomes.

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“…É importante considerar que ao longo dos últimos anos o subfinanciamento do SUS produziu acentuada redução de leitos assistenciais. Com a promulgação da Emenda Constitucional 95 (Teto de Gastos Públicos), em 2016, o país fixou o orçamento das políticas sociais por 20 anos, incluindo os recursos destinados à saúde 25 . Frente as emergências de saúde pública, como no caso desta pandemia, elevam-se as necessidades de investimento sem o acompanhamento orçamentário de médio e longo prazos.…”

Section: Contra a Tradição -A Contradição: Diálogos Entre As Estratégunclassified

Epidemiologia, políticas públicas e pandemia de Covid-19: o que esperar no Brasil? [Epidemiology, public policies and Covid-19 pandemics in Brazil: what can we expect?] [Epidemiologia, políticas públicas y la pandémia de Covid-19 en Brasil: que podemos esperar?]

et al. 2020

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Objetivo: discutir as experiências e contradições no controle da pandemia de Covid-19 sob a perspectiva da epidemiologia e das políticas públicas brasileiras. Conteúdo: o debate apresentado divide-se em duas seções: a primeira traça a reflexão dos parâmetros epidemiológicos sobre a curva epidêmica do SARS-CoV-2, bem como as experiências internacionais para o controle deste fenômeno. A segunda, ancorada nas políticas públicas brasileiras, apresenta uma análise comparada das experiências nacionais e internacionais, discutindo os potenciais reflexos sobre a pandemia, considerando algumas especificidades sociais. Conclusão: frente à impossibilidade de redução de pessoas susceptíveis por meio de estratégias vacinais, a redução da velocidade da curva epidêmica precisa ocorrer por meio de ações de isolamento físico social. Ademais, a construção de políticas públicas que visem a proteção ao trabalhador e a ampliação do investimento no setor saúde são medidas urgentes.ABSTRACTObjective: to discuss experiences and contradictions in the control of the Covid-19 pandemic from the perspective of epidemiology and Brazilian public policies. Content: the discussion presented is divided into two sections: the first one present epidemiological parameters on the epidemic curve of SARS-CoV-2, as well as the international experiences for the control of this phenomenon. The second, anchored in the Brazilian public policies, presents a comparative analysis of national and international experiences, discussing the potential impacts on the pandemic, considering some specific social issues. Conclusion: in the face of impossibility of reducing susceptible people through vaccination strategies, the reduction of the speed of the epidemic curve needs to occur through actions of social distance. In addition, the construction of public policies aimed at protecting workers and expanding investment in the health sector are urgent measures.RESUMÉNObjetivo: discutir las experiencias y contradicciones en el control de la pandemia Covid-19 desde la perspectiva de la epidemiología brasileña y las políticas públicas. Contenido: el debate presentado se divide en dos secciones. El primero traza la reflexión de los parámetros epidemiológicos en la curva epidémica del SARS-CoV-2, así como las experiencias internacionales para el control de este fenómeno. El segunda seccione, anclada en las políticas públicas brasileñas, presenta un análisis comparativo de las experiencias nacionales e internacionales, discutiendo los posibles impactos en la pandemia, considerando algunas especificidades sociales brasileñas. Conclusión: dada la imposibilidad de reducir a las personas susceptibles a través de estrategias de vacunación, la reducción de la velocidad de la curva epidémica debe ocurrir a través de acciones de aislamiento social y físico. Además, la construcción de políticas públicas destinadas a proteger a los trabajadores y ampliar la inversión en el sector de la salud son medidas urgentes.

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Subfinanciamento e orçamento federal do SUS: referências preliminares para a alocação adicional de recursos

Cited by 38 publications

References 4 publications

Health equity and COVID-19: global perspectives

Health equity and COVID-19: global perspectives

Improving the continuum of care monitoring in Brazilian HIV healthcare services: An implementation science approach

Epidemiologia, políticas públicas e pandemia de Covid-19: o que esperar no Brasil? [Epidemiology, public policies and Covid-19 pandemics in Brazil: what can we expect?] [Epidemiologia, políticas públicas y la pandémia de Covid-19 en Brasil: que podemos esperar?]

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