Descentralização e regionalização: dinâmica e condicionantes da implantação do Pacto pela Saúde no Brasil

Lima, Luciana Dias de; Queiroz, Lúcia F. N. de; Machado, Cristiani Vieira; Viana, Ana Luiza d’Ávila

doi:10.1590/s1413-81232012000700030

Cited by 68 publications

(62 citation statements)

References 10 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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“…Outra explicação seria a de que os Pactos estejam apresentando sucesso suficiente para retirar o tema das prioridades dos municípios. Essa probabilidade é menor, já que estudo abrangente e recente mostra a persistência de problemas nessa estratégia (LIMA ET AL., 2012).…”

Section: A Descentralização Do Sus E O Papel Da Esfera Municipalunclassified

Prefeitos eleitos, descentralização na saúde e os compromissos com o SUS

2016

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RESUMO O artigo analisa a municipalização na saúde por meio das proposições para a política de saúde de prefeitos eleitos no ano de 2012. Realizou-se análise documental das plataformas de governo dos então candidatos e de documentos oficiais da política e da gestão municipais de saúde -Relatórios das Conferências Municipais de Saúde e Planos Municipais de Saúde -de 24 municípios brasileiros nas cinco regiões do País. Os resultados indicam que os programas das candidaturas, em geral, incorporam a defesa do direito à saúde, embora principalmente através da ampliação da oferta de serviços médicos.PALAVRAS-CHAVE Política de saúde; Descentralização; Governo local. ' health policy and management, i.e., Municipal Health Conferences Reports and Municipal Health Plans, of 24 ABSTRACT The article analyzes the municipalization of health by means of propositions for health policy of mayors elected in the year 2012. Documentary analysis was carried out on the so candidates' government platforms and on official documents of the municipalities

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“…Analyzes about the municipalist realm of the Brazilian health system show diverse results and are strongly conditioned by the context of implementation, reflecting the realities of the municipalities and the political will of governmental stakeholders 1,5,6 . This setting has placed at the center of the debate the need to reconcile health policy decentralization with regionalization strategies in order to promote more complementary intergovernmental relations, balance autonomy and interdependence between government entities, encourage the formalization of agreements and organize an integrated health system at regional level 5,[7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…Norms and guidelines were then published to give materiality to regionalization 2,5,7,8 . In this process, parameters were established to define territorial distribution (health regions) and interregional collegiates were established, with representatives of the different spheres of government responsible for conducting health policy at the regional level 8 .…”

Section: Introductionmentioning

confidence: 99%

A implementação de redes de atenção e os desafios da governança regional em saúde na Amazônia Legal: uma análise do Projeto QualiSUS-Rede

Casanova

Cruz

Giovanella

et al. 2017

Ciênc. saúde coletiva

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Descentralização e regionalização: dinâmica e condicionantes da implantação do Pacto pela Saúde no Brasil

Abstract: Descentralização e regionalização: dinâmica e condicionantes da implantação do Pacto pela Saúde no Brasil

Cited by 68 publications

References 10 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

Prefeitos eleitos, descentralização na saúde e os compromissos com o SUS

A implementação de redes de atenção e os desafios da governança regional em saúde na Amazônia Legal: uma análise do Projeto QualiSUS-Rede

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