Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | spa por |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794 |
Resumo: | Since the Declaration of Alma-Ata in 1978, primary healthcare (PHC) is considered an essential component of health systems. In the Chilean case, management of primary care was municipalized during the dictatorship and maintained by the subsequent governments, with some reforms. The aim of this article was to estimate and analyze spending in PHC in Chile, during the governments of Sebastián Piñera and Michelle Bachelet. Collection of financial data was oriented by the model of National Health Accounts (CNS), and later the amounts were deflated according to the Consumer Price Index. The principal source of information was the National System of Municipal Information (SINIM). The results show that during the period there was a permanent increase in spending in PHC; however, the average percent change was slightly higher in the first government compared to the second. The percentage of spending in PHC in relation to public spending in health was 21.4% for the eight years, with few variations. Indicators show that inequalities between administrative and health regions are increasing steadily. Therefore, although transfers to fund primary care services are increasing, they may be poorly distributed. This and other problems like the commodification of services and dismantlement of the network compromise the consolidation of PHC, especially in a health system based on contributive insurance like the Chilean system. |
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Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorialGasto em atenção primária à saúde em dois governos do Chile pós-ditaduraFinanciación de la Atención de la SaludAtención Primaria de SaludGastos en SaludFinanciamento da Assistência à SaúdeAtenção à Primária à SaúdeGastos em SaúdeSince the Declaration of Alma-Ata in 1978, primary healthcare (PHC) is considered an essential component of health systems. In the Chilean case, management of primary care was municipalized during the dictatorship and maintained by the subsequent governments, with some reforms. The aim of this article was to estimate and analyze spending in PHC in Chile, during the governments of Sebastián Piñera and Michelle Bachelet. Collection of financial data was oriented by the model of National Health Accounts (CNS), and later the amounts were deflated according to the Consumer Price Index. The principal source of information was the National System of Municipal Information (SINIM). The results show that during the period there was a permanent increase in spending in PHC; however, the average percent change was slightly higher in the first government compared to the second. The percentage of spending in PHC in relation to public spending in health was 21.4% for the eight years, with few variations. Indicators show that inequalities between administrative and health regions are increasing steadily. Therefore, although transfers to fund primary care services are increasing, they may be poorly distributed. This and other problems like the commodification of services and dismantlement of the network compromise the consolidation of PHC, especially in a health system based on contributive insurance like the Chilean system.Desde la Declaración de Alma-Ata, en 1978, la atención primaria en salud (APS) está considerada un componente esencial de los sistemas de salud. En el caso chileno, la gestión de la atención primaria fue municipalizada durante la dictadura, y mantenida por los gobiernos posteriores con algunas reformas. El objetivo de este trabajo fue estimar y analizar el gasto en APS en Chile, durante los gobiernos de Sebastián Piñera y Michelle Bachelet. La recogida de datos financieros estuvo orientada por el Modelo de Cuentas Nacionales en Salud (CNS) y, posteriormente, los valores fueron deflactados según el Índice de Precios al Consumidor (IPC). La principal fuente de información fue el Sistema Nacional de Información Municipal (SINIM). Los resultados muestran que durante el período hubo un aumento permanente del gasto en APS; no obstante, la media de variación porcentual fue un poco mayor en el primer gobierno que en el segundo. El porcentaje del gasto en APS, en relación con el gasto público en salud fue de un 21,4% para los ocho años, teniendo pocas variaciones. Los indicadores muestran que la desigualdad entre las regiones administrativas y de salud está ampliándose progresivamente. Por ello, los fondos destinados a financiar los servicios ofrecidos en atención primaria, aunque crecientes, posiblemente están siendo mal distribuidos. Todo ello, junto con otros problemas, como la mercantilización de los servicios y la desintegración de la red, perjudica la consolidación de la APS, sobre todo si se trata de un sistema de salud basado en seguros contributivos como el chileno.Desde a Declaração de Alma-Ata, em 1978, a atenção primária à saúde (APS) é considerada componente essencial dos sistemas de saúde. No caso chileno, a gestão da atenção primária foi municipalizada durante a ditadura e mantida pelos governos posteriores, com algumas reformas. O objetivo deste trabalho foi estimar e analisar o gasto em APS no Chile, durante os governos de Sebastián Piñera e Michelle Bachelet. A coleta dos dados financeiros foi orientada pelo Modelo de Contas Nacionais em Saúde (CNS) e, posteriormente, os valores foram deflacionados segundo o Índice de Preços do Consumidor (IPC). A principal fonte das informações foi o Sistema Nacional de Informação Municipal (SINIM). Os resultados mostram que no período houve aumento permanente do gasto em APS, entretanto, a média de variação percentual foi um pouco maior no primeiro governo do que no segundo. A porcentagem do gasto em APS em relação ao gasto público com saúde foi de 21,4% para os oito anos, tendo poucas variações. Indicadores mostram que a desigualdade entre as regiões administrativas e de saúde está ampliando progressivamente. Por tanto, os repasses destinados a financiar os serviços oferecidos na atenção primária, se bem que crescentes, possivelmente estão sendo mal distribuídos. Isso, junto com outros problemas, como a mercantilização dos serviços e a desintegração da rede, prejudicam a consolidação da APS, sobretudo tratando-se de um sistema de saúde baseado em seguros contributivos como o chileno.Reports in Public HealthCadernos de Saúde Pública2021-04-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794Reports in Public Health; Vol. 37 No. 3 (2021): MarchCadernos de Saúde Pública; v. 37 n. 3 (2021): Março1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZspaporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17422https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17423https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17424https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17425Fabián Moraga-CortésThereza Christina BahiaClara Aleida Pradainfo:eu-repo/semantics/openAccess2024-03-06T15:30:09Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/7794Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:08:57.528074Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial Gasto em atenção primária à saúde em dois governos do Chile pós-ditadura |
title |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial |
spellingShingle |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial Fabián Moraga-Cortés Financiación de la Atención de la Salud Atención Primaria de Salud Gastos en Salud Financiamento da Assistência à Saúde Atenção à Primária à Saúde Gastos em Saúde |
title_short |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial |
title_full |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial |
title_fullStr |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial |
title_full_unstemmed |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial |
title_sort |
Gasto en atención primaria en salud en dos gobiernos del Chile posdictatorial |
author |
Fabián Moraga-Cortés |
author_facet |
Fabián Moraga-Cortés Thereza Christina Bahia Clara Aleida Prada |
author_role |
author |
author2 |
Thereza Christina Bahia Clara Aleida Prada |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Fabián Moraga-Cortés Thereza Christina Bahia Clara Aleida Prada |
dc.subject.por.fl_str_mv |
Financiación de la Atención de la Salud Atención Primaria de Salud Gastos en Salud Financiamento da Assistência à Saúde Atenção à Primária à Saúde Gastos em Saúde |
topic |
Financiación de la Atención de la Salud Atención Primaria de Salud Gastos en Salud Financiamento da Assistência à Saúde Atenção à Primária à Saúde Gastos em Saúde |
description |
Since the Declaration of Alma-Ata in 1978, primary healthcare (PHC) is considered an essential component of health systems. In the Chilean case, management of primary care was municipalized during the dictatorship and maintained by the subsequent governments, with some reforms. The aim of this article was to estimate and analyze spending in PHC in Chile, during the governments of Sebastián Piñera and Michelle Bachelet. Collection of financial data was oriented by the model of National Health Accounts (CNS), and later the amounts were deflated according to the Consumer Price Index. The principal source of information was the National System of Municipal Information (SINIM). The results show that during the period there was a permanent increase in spending in PHC; however, the average percent change was slightly higher in the first government compared to the second. The percentage of spending in PHC in relation to public spending in health was 21.4% for the eight years, with few variations. Indicators show that inequalities between administrative and health regions are increasing steadily. Therefore, although transfers to fund primary care services are increasing, they may be poorly distributed. This and other problems like the commodification of services and dismantlement of the network compromise the consolidation of PHC, especially in a health system based on contributive insurance like the Chilean system. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-04-07 |
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://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794 |
dc.language.iso.fl_str_mv |
spa por |
language |
spa por |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17422 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17423 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17424 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7794/17425 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html text/html application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 37 No. 3 (2021): March Cadernos de Saúde Pública; v. 37 n. 3 (2021): Março 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943394827862016 |