Mudanças recentes no financiamento federal do Sistema Único de Saúde: atenção básica à saúde

Solla, Jorge José Santos Pereira; Chioro, Arthur; Sóter, Ana Paula Menezes; Fernandes, Afra Suassuna; Palma, José João Lanceiro de

doi:10.1590/s1519-38292007000400018

Cited by 22 publications

(28 citation statements)

References 9 publications

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“…In 2004, only 14 cities in Rio Grande do Sul, Pelotas among them, had taken full control of the local health care system. At the state -level, the percentage of cities adopting the rules delineated by the health pact ("pacto pela saúde") was less than 50% 25 even though the latter is defined as a priority 1,26,27 . The previous study conducted in Pelotas using a shorter list of primary care-sensitive conditions showed that spending on HPCSC represented 4.8% and 14.6% of hospitalization costs in the city 14 .…”

Section: Discussionmentioning

confidence: 99%

Hospitalizações por condições sensíveis à atenção primária em Pelotas: 1998 a 2012

Costa

Teixeira

Moraes

et al. 2017

Rev. bras. epidemiol.

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ABSTRACT:Objective: To verify the hospitalization trend for primary care sensitive-conditions in Pelotas, Rio Grande do Sul, Brazil from 1998 to 2012. Methods: An ecological study compared hospitalizations rates of the city of Pelotas with the rest of state of Rio Grande do Sul. Analysis was conducted using direct standardization of rates, coefficients were stratified by sex and the Poisson regression was used. Results: Hospitalizations for sensitive conditions decreased in Pelotas and Rio Grande do Sul. In Pelotas, a 63.8% decrease was detected in the period observed, and there was a 43.1% decrease in the state of Rio Grande do Sul. Poisson regression coefficients showed a decrease of 7% in Pelotas and of 4% in the rest of Rio Grande do Sul each year. Conclusion: During the study period, several changes were introduced in the Brazilian Unified Health System ("Sistema Único de Saúde") that may have influenced the results, including changes in administration, health funding, and a complete reworking of primary care through the creation of the Family Health Strategy program ("Estratégia Saúde da Família"). . Since its creation, SUS underwent several modifications such as changes in its organizational structure, funding, primary care models, and the implementation of assorted measures, increasing the need for adequate programs and health actions evaluation 4 . An alternative to primary care evaluation is monitoring the hospitalization rates for primary care-sensitive conditions (HPCSC). Primary care-sensitive conditions are a set of 20 groups of diseases for which treatment at the right time could reduce or eliminate the risk of hospitalization, both by preventing their emergence and by adequately handling the condition 5 . Thus, proper coverage at the primary care level can decrease admission rates as services become more effective. A health care system that could adequately handle diseases prone to ambulatory control would present an appropriate effectiveness level 6,7 . In the same way, studies have shown that primary health care provision can be crucial for improving health condition in the population 8,9 . The Brazilian Ministry of Health (Ministério da Saúde) has published a list of primary care-sensitive diseases in Decree n. 221 of April 17, 2008, in which it is proposed that such indicator would evaluate the effectiveness level of the system and/or of hospital care 10 , thus acknowledging its importance. Based on this list, several inquiries have analyzed the behavior of HPCSC. An ecological study showed that HPCSC decreased by 24% between 1999 and 2007 in Brazil. Such decrease was also observed when comparing this group of

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Section: Discussionmentioning

confidence: 99%

Hospitalizações por condições sensíveis à atenção primária em Pelotas: 1998 a 2012

Costa

Teixeira

Moraes

et al. 2017

Rev. bras. epidemiol.

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“…In the municipalities, 71% of the interviewees After the changes to the PHC funding criteria and the ACS´s coverage parameters, when each agent was allowed to monitor fewer people, there was an increase of 7,435 new ACS in the region (20) . This expansion may have generated positive impacts, but a contingent of the population is still not being covered, suggesting the need for a greater increase in the number of teams and professionals to monitor the families.…”

Section: Revmentioning

confidence: 99%

“…This expansion may have generated positive impacts, but a contingent of the population is still not being covered, suggesting the need for a greater increase in the number of teams and professionals to monitor the families. The ACS's presence is not enough, because he or she must be trained, The gradual expansion of the ESF teams and the number of ACS (20) , which is currently occurring in the region, can be seen as a positive factor. Other factors that have been favoring PHC integration and the fight against malaria related to the PNCM, include: rapid diagnosis Ferreira ACS, Suárez-Mutis MC, Campos MR, Osorio-de-Castro CGS.…”

Section: Revmentioning

confidence: 99%

Primary health care in municipalities at high risk for malaria

Ferreira

Suárez-Mútis

Campos³

et al. 2011

Rev. Latino-Am. Enfermagem

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This study aims to characterize aspects of Primary Health Care in the Amazon Region of Brazil, considered as the main endemic area for malaria in the country. The Ministry of Health recommends the expansion of Primary Health Care in endemic areas for malaria. A survey focusing on patients infected with malaria was conducted in 6 municipalities, in January and February 2007, to investigate specific aspects of Primary Health Care. Data was analyzed quantitatively and field records helped to give support to context and policy issues in the visited sites. Quality of access to health services and medicines, continuity of health care, system coordination and community orientation are still incipient in the visited areas. The study showed that there is little integration between Primary Health Care and malaria control in the region, which calls for development of joint strategies and for the strengthening of Primary Health Care per se, as a benefit to the population of this endemic area.

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“…Além disso, ainda que de forma tímida, pela primeira vez foram empregados indicadores de condições sociais como critério para diferenciar os repasses federais relativos à atenção básica aos municípios. A utilização desses indicadores está associada à busca da eqüidade no âmbito do financiamento do SUS 15 , uma das atribuições do gestor federal na implementação de um sistema nacional de saúde em um país federativo e desigual como o Brasil.…”

Section: Metodologiaunclassified

“…Entre 1998 e 1999, a linha que corresponde ao PAB fixo apresenta crescimento, pois a introdução deste incentivo produziu uma elevação dos recursos federais transferidos da atenção básica para a maioria absoluta dos municípios brasileiros 15 …”

Section: Metodologiaunclassified

A política de atenção primária à saúde no Brasil: notas sobre a regulação e o financiamento federal

Castro

Machado

2010

Cad. Saúde Pública

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O artigo analisa a condução federal da política de atenção primária à saúde no Brasil de 2003 a 2008, considerando as funções de Estado na saúde de planejamento, regulação, financiamento e execução direta de serviços. A pesquisa compreendeu revisão bibliográfica, realização de entrevistas semi-estruturadas com atores-chave da política, análise documental, orçamentária e de bases de dados secundários. Observou-se redução na execução federal direta das ações e fragilidades no que diz respeito ao planejamento. A atuação federal se caracterizou principalmente pela regulação, baseada na emissão de portarias atreladas a mecanismos financeiros. No que concerne ao financiamento, houve discreto aumento da participação da atenção básica no orçamento federal, reajustes e criação de novos incentivos, alguns visando à eqüidade. Embora tenham ocorrido avanços no período, permanece o desafio de reconuração do modelo regulatório federal e a garantia de um aporte maior de recursos para este nível de atenção, a fim de que ocorra o efetivo fortalecimento da atenção primária no país.

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Mudanças recentes no financiamento federal do Sistema Único de Saúde: atenção básica à saúde

Cited by 22 publications

References 9 publications

Hospitalizações por condições sensíveis à atenção primária em Pelotas: 1998 a 2012

Hospitalizações por condições sensíveis à atenção primária em Pelotas: 1998 a 2012

Primary health care in municipalities at high risk for malaria

A política de atenção primária à saúde no Brasil: notas sobre a regulação e o financiamento federal

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