Saúde da Família: características do financiamento para municípios selecionados no Paraná

• Autor(a) principal: Veiga, Silvia Ivone de Paula
• Data de Publicação: 2009
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4196
• topic: Unified Health System; Funding; Family Health Strategy; Sistema Único de Saúde; Financiamento; Estratégia Saúde da Família; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

This study aimed to analyze the characteristics of funding for primary care and the Family Health Program (FHP) in the 10th RS of Paraná State, and its relationship to induce the health care model. It identifies the revenue performance for the PSF in the 10th RS of Paraná, the behavior of the costs of primary care in relation to total expenditure on health and the role of regional financial incentives to induce the PSF maintenance and expansion of the PSF in health care of selected municipalities. The stable and sufficient funding is essential for the access of all Brazilian citizens to actions and health services. The implementation of the SUS brings a challenge in health care change: from restricted access to INPS beneficiaries to universal access, the SUS guarantees health as a right and duty of the State, by adopting policies that are the pillars of the transition from curative to preventive actions based on integral care. The challenges for change in health care are closely linked to the financing challenges. The constant struggle for funding and attempts to link the revenue to ensure the stability and adequacy of resources for the SUS are mandatory for the system to give account to meet all citizens. The 10th Regional Health of the State of Paraná, located in the city of Cascavel, comprises 25 municipalities, and only one has implemented the strategy of Family Health Program. For the analysis of the financing of primary care and the PSF for the case analyzed, we used data from official systems of information of public character, namely: Information System on Public Health Budget (SIOPS), National Register of Health Establishments (CNES), National Department of Primary Care (DAB) and the National Health Fund (FNS). From the analysis of data, it was possible to identify the inductive role of resources in variable PAB to the PSF in the municipalities, as most have less than 20,000 inhabitants and the organization of services at municipal level is the sole primary care level. Intergovernmental transfers, including financial incentives, have a high share of total resources of the municipalities, but the management capacity and the possibility of deployment of the teams acting in the way that they propose to adopt the ESF must be revised and discussed at the municipal level so that the implementation of the strategy is not the only way in which municipalities are seeking resources. Thus, the federal government remains the defining agent of health policy in the country. In a country where the cities are characterized by extremely heterogeneous in size and income, the federal funds must comply and continue to fulfill the key role in supporting the PSF, which is confirmed in the cities analyzed.