Distribution of health facilities in Brazil: what model are we seeking?

• Autor(a) principal: Scatena, João Henrique Gurtler
• Data de Publicação: 1998
• Outros Autores: Tanaka, Oswaldo Yoshimi
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista de Administração Pública
• Texto Completo: https://periodicos.fgv.br/rap/article/view/7777
• topic: Brazilian constitutions; health legislation; health equipment; municipalization; Unified Health System.; constituciones de Brasil; legislación de salud; establecimientos de salud; municipalización; Sistema Único de Salud; constituições brasileiras; legislação de saúde; equipamentos de saúde; municipalização; Sistema Único de Saúde.

Brazilian municipalities have been fundamental for the feasibility of the National Health System (SUS). This paper raises, in the last 170 years, the most important constitutional aspects of the municipalities' roles in relation to health and as part of the State. The 1984-92 period is detailed through the analysis of the distribution trend of Brazilian health facilities. In this period, the municipal districts have invested massively in all kind ofhealth facilities, being responsible, in 1992, for 61,6% of the health stations and for 74,8% of the health centers. The federal and state governments gradually decrease their participation on health facilities, while the private sector maintains the majority of the outpatient clinics and hospitals, reordering its participation in the hospital sector. The distribution dynamics of the health facilities has, over the time, several and distinct political and conjuncture determinants, the knowledge of which is indispensable for choosing better strategies and mechanisms to make the SUS more effective.