Primary health care financing changes in the Brazilian Health System: advance ou setback?

被引:50
作者
Massuda, Adriano [1 ]
机构
[1] Fundacao Getulio Vargas, Escola Adm Estado Sao Paulo, Av 9 Julho 2029-11 FGVsaude, BR-01313902 Sao Paulo, SP, Brazil
来源
CIENCIA & SAUDE COLETIVA | 2020年 / 25卷 / 04期
关键词
Primary Health Care; Health Financing; Unified Health System; MORTALITY;
D O I
10.1590/1413-81232020254.01022020
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
In 2019, the Brazilian government launched a new Primary Health Care (PHC) policy for the Unified Health System (SUS). Called "PrevineBrasil", the policy changed the PHC funding for municipalities. Instead of inhabitants and Family Health Strategy (ESF) teams, intergovernmental transfers are calculated from the number of people registered in PHC services and the results achieved in a selected group of indicators. The changes will have a set of impacts for the SUS and the health of the population, which must be observed and monitored. In this paper, possible effects of the new policy are discussed from a brief context analysis of global trends in health systems financing and health services' remuneration models, as well as on the advances, challenges, and threats to PHC and the SUS. Based on the analysis, the new policy seems to have a restrictive purpose, which should limit universality, increase distortions in financing and induce the focus of PHC actions on the SUS, contributing to the reversal of historic achievements in reducing health inequalities in Brazil.
引用
收藏
页码:1181 / 1188
页数:8
相关论文
共 33 条
[1]   Transition to universal primary health care coverage in Brazil: Analysis of uptake and expansion patterns of Brazil's Family Health Strategy (1998-2012) [J].
Andrade, Monica Viegas ;
Coelho, Augusto Quaresma ;
Xavier Neto, Mauro ;
de Carvalho, Lucas Resende ;
Atun, Rifat ;
Castro, Marcia C. .
PLOS ONE, 2018, 13 (08)
[2]  
Associacao Brasileira de Saude Coletiva (Abrasco), NOT ABR PROP MUD PNA
[3]   PREPARATION AND CHARACTERIZATION OF NANOSTRUCTURED FILMS: STUDY OF HYDROPHOBICITY AND ANTIBACTERIAL PROPERTIES FOR SURFACE PROTECTION [J].
Barberio, M. ;
Veltri, S. ;
Sokullu, E. ;
Xu, F. ;
Gauthier, M. A. ;
Antici, P. .
ADVANCED PROCESSING AND MANUFACTURING TECHNOLOGIES FOR NANOSTRUCTURED AND MULTIFUNCTIONAL MATERIALS II, 2016, :101-111
[4]  
Blomqvist Ake., 2011, The Oxford Handbook of Health Economics, P257
[5]  
Brasil. Ministerio da Saude (MS), 2015, NUM SAUD FAM
[6]  
Brasil. Ministerio da Saude (MS), 2019, PORT N 2 979 12 NOV
[7]  
Brasil. Ministerio da Saude (MS), 2019, PROGR PREV BRAS QUER
[8]   Brazil's unified health system: the first 30 years and prospects for the future [J].
Castro, Marcia C. ;
Massuda, Adriano ;
Almeida, Gisele ;
Menezes-Filho, Naercio Aquino ;
Andrade, Monica Viegas ;
Micaela de Souza Noronha, Kenya Valeria ;
Rocha, Rudi ;
Macinko, James ;
Hone, Thomas ;
Tasca, Renato ;
Giovanella, Ligia ;
Malik, Ana Maria ;
Werneck, Heitor ;
Fachini, Luiz Augusto ;
Atun, Rifat .
LANCET, 2019, 394 (10195) :345-356
[9]   Creation of the Primary Health Care Secretariat and its implications for SUS [J].
dos Reis, Joao Gabbardo ;
Harzheim, Erno ;
Abrao Nachif, Maria Cristina ;
de Freitas, Juliana Carla ;
D'Avila, Otavio ;
Hauser, Lisiane ;
Martins, Caroline ;
Pedebos, Lucas Alexandre ;
Pinto, Luiz Felipe .
CIENCIA & SAUDE COLETIVA, 2019, 24 (09) :3457-3462
[10]  
Facchini Luiz Augusto, 2018, Saúde debate, V42, P208, DOI 10.1590/0103-11042018s114