Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Cadernos Ibero-Americanos de Direito Sanitário (Online) |
Texto Completo: | https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/724 |
Resumo: | Objective: to analyze the equity in the distribution of resources of primary health care in municipalities of the state of Ceará. Methods: this is an ecological study, using secondary data from the public domain of 184 municipalities in Ceará, between 2004 and 2014. Population data were collected at the Informatics Department of the Unified Health System; resources were received from the cost of primary care in the National Health Fund and municipal development index in the Institute of Research and Economic Strategy of Ceará. The expenditure on total primary care and per capita was calculated by population size of the municipalities, and the analysis was performed using scatterplots and boxplots. Results: a sequential increase variation was revealed between large municipalities> small municipalities> medium-sized municipalities. Per capita spending on primary care are varied: medium-sized municipalities> large municipalities> small-sized municipalities. Between 2000 and 2014, spending on primary health care per capita stands out in small municipalities, from R $ 45.23 (2004) to R $ 132.97 (2014); in medium-sized municipalities from R $ 32.52 to R $ 97.05; and large municipalities, from R $ 29.14 to R $ 82.10. Graphical analyzes found greater growth in spending between small municipalities, from 2004 to 2012, decreasing in 2014. Conclusion: the federal government's primary health care financing policy benefited small municipalities, with an increasing trend of resources between 2000 and 2000. 2012, however, in 2014, this trend was reversed, which is worrying for the maintenance of Primary Care as the basis of the Unified Health System. |
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Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, BrazilAnálisis de equidad en la distribución del financiamiento federal a la atención primaria de salud entre los municipios de Ceará, BrasilAnálise da equidade na distribuição do financiamento federal à Atenção Primária à Saúde entre os municípios do CearáEquidadFinanciaciónPrimeros auxiliosEquityFinancingPrimary health careEquidadeFinanciamentoAtenção Primária à SaúdeObjective: to analyze the equity in the distribution of resources of primary health care in municipalities of the state of Ceará. Methods: this is an ecological study, using secondary data from the public domain of 184 municipalities in Ceará, between 2004 and 2014. Population data were collected at the Informatics Department of the Unified Health System; resources were received from the cost of primary care in the National Health Fund and municipal development index in the Institute of Research and Economic Strategy of Ceará. The expenditure on total primary care and per capita was calculated by population size of the municipalities, and the analysis was performed using scatterplots and boxplots. Results: a sequential increase variation was revealed between large municipalities> small municipalities> medium-sized municipalities. Per capita spending on primary care are varied: medium-sized municipalities> large municipalities> small-sized municipalities. Between 2000 and 2014, spending on primary health care per capita stands out in small municipalities, from R $ 45.23 (2004) to R $ 132.97 (2014); in medium-sized municipalities from R $ 32.52 to R $ 97.05; and large municipalities, from R $ 29.14 to R $ 82.10. Graphical analyzes found greater growth in spending between small municipalities, from 2004 to 2012, decreasing in 2014. Conclusion: the federal government's primary health care financing policy benefited small municipalities, with an increasing trend of resources between 2000 and 2000. 2012, however, in 2014, this trend was reversed, which is worrying for the maintenance of Primary Care as the basis of the Unified Health System.Objetivo: analizar la equidad en la distribución de recursos de Atención Primaria de Salud en los municipios del estado de Ceará. Metodología: se trata de un estudio ecológico, utilizando datos secundarios de dominio público de 184 municipios de Ceará, entre 2004 y 2014. Los datos poblacionales fueron recolectados en el Departamento de Informática del Sistema Único de Salud; recursos recibidos del costo de atención primaria en el Fondo Nacional de Salud e índice de desarrollo municipal en el Instituto de Investigación y Estrategia Económica de Ceará. El gasto en atención primaria total y per cápita se calculó por tamaño de población de los municipios, y el análisis se realizó mediante diagramas de dispersión y diagramas de caja. Resultados: se reveló una variación de aumento secuencial entre municipios grandes> municipios pequeños> municipios medianos. El gasto per cápita en atención primaria varió: municipios medianos> municipios grandes> municipios pequeños. Entre 2000 y 2014, se destaca el gasto en atención primaria de salud per cápita en los municipios pequeños, de R $ 45,23 (2004) a R $ 132,97 (2014); en municipios medianos de R $ 32,52 a R $ 97,05; y grandes municipios, de R $ 29,14 a R $ 82,10. Los análisis gráficos encontraron un mayor crecimiento en el gasto entre municipios pequeños, de 2004 a 2012, disminuyendo en 2014. Conclusión: la política de financiamiento de la atención primaria de salud del gobierno federal benefició a los municipios pequeños, con una tendencia creciente de recursos entre 2000 y 2000. 2012, sin embargo, en En 2014 se revirtió esta tendencia, preocupante para el mantenimiento de la Atención Primaria como base del Sistema Único de Salud.Objetivo: analisar a equidade na distribuição dos recursos da Atenção Primária à Saúde nos municípios do estado do Ceará. Metodologia: trata-se de um estudo ecológico, utilizando dados secundários de domínio público dos 184 municípios cearenses, entre 2004 e 2014. Coletou-se dados populacionais no Departamento de Informática do Sistema Único de Saúde; recursos recebidos de custeio da atenção primária no Fundo Nacional de Saúde e índice de desenvolvimento municipal no Instituto de Pesquisa e Estratégia Econômica do Ceará. Calculou-se o gasto com atenção básica total e per capita por porte populacional dos municípios, sendo a análise realizada por gráficos de dispersão e boxplot. Resultados: foi revelada variação de aumento sequencial entre municípios de grande porte>municípios de pequeno porte>municípios de médio porte. O gasto per capita com a atenção básica apresentou variação: municípios de médio porte>municípios de grande porte>municípios de pequeno porte. Entre 2000 e 2014, o gasto com atenção básica per capita sobressai nos municípios de pequeno porte, passando de R$ 45,23 (2004) para R$ 132,97 (2014); nos municípios de médio porte de R$ 32,52 para R$ 97,05; e municípios de grande porte, de R$ 29,14 para R$ 82,10. Análises gráficas constataram maior crescimento dos gastos entre municípios de pequeno porte, de 2004 e 2012, apresentando queda em 2014. Conclusão: a política de financiamento da atenção primária do governo federal beneficiou os municípios de pequeno porte, apresentando tendência crescente de recursos entre 2000 e 2012, porém, em 2014, essa tendência se inverteu, o que é preocupante para a manutenção da Atenção Primária como base do Sistema Único de Saúde.Fundação Oswaldo Cruz Brasília2021-03-18info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/72410.17566/ciads.v10i1.724Iberoamerican Journal of Health Law; Vol. 10 No. 1 (2021): (JAN./MAR. 2021); 76-92Cuadernos Iberoamericanos de Derecho Sanitario; Vol. 10 Núm. 1 (2021): (ENE./MAR. 2021); 76-92Cadernos Ibero-Americanos de Direito Sanitário; v. 10 n. 1 (2021): (JAN./MAR. 2021); 76-922358-18242317-839610.17566/ciads.v10i1reponame:Cadernos Ibero-Americanos de Direito Sanitário (Online)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZporhttps://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/724/792Copyright (c) 2021 Natália Lima Sousa, Maria Helena Lima Sousa, Marcelo Gurgel Carlos da Silvahttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessSousa, Natália LimaSousa, Maria Helena LimaSilva, Marcelo Gurgel Carlos daSousa, Natália LimaSousa, Maria Helena LimaSilva, Marcelo Gurgel Carlos daSousa, Natália LimaSousa, Maria Helena LimaSilva, Marcelo Gurgel Carlos da2022-06-21T18:59:32Zoai:ojs.cadernos.prodisa.fiocruz.br:article/724Revistahttp://www.cadernos.prodisa.fiocruz.brPUBhttp://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/oaicadernos.direitosanitario@fiocruz.br2358-18242317-8396opendoar:2022-06-21T18:59:32Cadernos Ibero-Americanos de Direito Sanitário (Online) - Fundação Oswaldo Cruz (FIOCRUZ)false |
dc.title.none.fl_str_mv |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil Análisis de equidad en la distribución del financiamiento federal a la atención primaria de salud entre los municipios de Ceará, Brasil Análise da equidade na distribuição do financiamento federal à Atenção Primária à Saúde entre os municípios do Ceará |
title |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil |
spellingShingle |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil Sousa, Natália Lima Equidad Financiación Primeros auxilios Equity Financing Primary health care Equidade Financiamento Atenção Primária à Saúde |
title_short |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil |
title_full |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil |
title_fullStr |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil |
title_full_unstemmed |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil |
title_sort |
Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil |
author |
Sousa, Natália Lima |
author_facet |
Sousa, Natália Lima Sousa, Maria Helena Lima Silva, Marcelo Gurgel Carlos da |
author_role |
author |
author2 |
Sousa, Maria Helena Lima Silva, Marcelo Gurgel Carlos da |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Sousa, Natália Lima Sousa, Maria Helena Lima Silva, Marcelo Gurgel Carlos da Sousa, Natália Lima Sousa, Maria Helena Lima Silva, Marcelo Gurgel Carlos da Sousa, Natália Lima Sousa, Maria Helena Lima Silva, Marcelo Gurgel Carlos da |
dc.subject.por.fl_str_mv |
Equidad Financiación Primeros auxilios Equity Financing Primary health care Equidade Financiamento Atenção Primária à Saúde |
topic |
Equidad Financiación Primeros auxilios Equity Financing Primary health care Equidade Financiamento Atenção Primária à Saúde |
description |
Objective: to analyze the equity in the distribution of resources of primary health care in municipalities of the state of Ceará. Methods: this is an ecological study, using secondary data from the public domain of 184 municipalities in Ceará, between 2004 and 2014. Population data were collected at the Informatics Department of the Unified Health System; resources were received from the cost of primary care in the National Health Fund and municipal development index in the Institute of Research and Economic Strategy of Ceará. The expenditure on total primary care and per capita was calculated by population size of the municipalities, and the analysis was performed using scatterplots and boxplots. Results: a sequential increase variation was revealed between large municipalities> small municipalities> medium-sized municipalities. Per capita spending on primary care are varied: medium-sized municipalities> large municipalities> small-sized municipalities. Between 2000 and 2014, spending on primary health care per capita stands out in small municipalities, from R $ 45.23 (2004) to R $ 132.97 (2014); in medium-sized municipalities from R $ 32.52 to R $ 97.05; and large municipalities, from R $ 29.14 to R $ 82.10. Graphical analyzes found greater growth in spending between small municipalities, from 2004 to 2012, decreasing in 2014. Conclusion: the federal government's primary health care financing policy benefited small municipalities, with an increasing trend of resources between 2000 and 2000. 2012, however, in 2014, this trend was reversed, which is worrying for the maintenance of Primary Care as the basis of the Unified Health System. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-03-18 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/724 10.17566/ciads.v10i1.724 |
url |
https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/724 |
identifier_str_mv |
10.17566/ciads.v10i1.724 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/724/792 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Natália Lima Sousa, Maria Helena Lima Sousa, Marcelo Gurgel Carlos da Silva https://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Natália Lima Sousa, Maria Helena Lima Sousa, Marcelo Gurgel Carlos da Silva https://creativecommons.org/licenses/by-nc/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Fundação Oswaldo Cruz Brasília |
publisher.none.fl_str_mv |
Fundação Oswaldo Cruz Brasília |
dc.source.none.fl_str_mv |
Iberoamerican Journal of Health Law; Vol. 10 No. 1 (2021): (JAN./MAR. 2021); 76-92 Cuadernos Iberoamericanos de Derecho Sanitario; Vol. 10 Núm. 1 (2021): (ENE./MAR. 2021); 76-92 Cadernos Ibero-Americanos de Direito Sanitário; v. 10 n. 1 (2021): (JAN./MAR. 2021); 76-92 2358-1824 2317-8396 10.17566/ciads.v10i1 reponame:Cadernos Ibero-Americanos de Direito Sanitário (Online) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
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Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos Ibero-Americanos de Direito Sanitário (Online) |
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Cadernos Ibero-Americanos de Direito Sanitário (Online) |
repository.name.fl_str_mv |
Cadernos Ibero-Americanos de Direito Sanitário (Online) - Fundação Oswaldo Cruz (FIOCRUZ) |
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cadernos.direitosanitario@fiocruz.br |
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