Analysis of equity in the distribution of federal funding to primary health care among the municipalities of Ceará, Brazil

Detalhes bibliográficos
Autor(a) principal: Sousa, Natália Lima
Data de Publicação: 2021
Outros Autores: Sousa, Maria Helena Lima, Silva, Marcelo Gurgel Carlos da
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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spelling 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
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos Ibero-Americanos de Direito Sanitário (Online)
collection Cadernos Ibero-Americanos de Direito Sanitário (Online)
repository.name.fl_str_mv Cadernos Ibero-Americanos de Direito Sanitário (Online) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos.direitosanitario@fiocruz.br
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