Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/206155 |
Resumo: | OBJECTIVE: Analyze the implications of parliamentary amendments (EP) for the model of equitable allocation of resources from the Fixed Primary Care Minimum (PAB-Fixo) to municipalities in the period from 2015 to 2019. METHODS: A descriptive and exploratory study was conducted on allocating federal resources to the PAB-Fixo and on the increment in the PAB by parliamentary amendment. The municipalities were classified into four groups according to degrees of socioeconomic vulnerability defined by the Ministry of Health for the allocation of PAB-Fixo resources. The transfers from the Ministry by parliamentary amendment were identified. The proportions of municipalities benefiting per group were analyzed by resources allocated from the PAB-Fixo and increment to the minimum by EP. RESULTS: There were reduced resources allocated to the PAB-Fixo (from R$ 6.04 billion to R$ 5.51 billion, -8.8%) and increased increment to PAB by parliamentary amendment (from R$ 95.06 million to R$ 5.58 billion, 5.767%) between 2015 and 2019. The participation of municipalities by the group of those favored by EP was similar to that in the PAB-Fixo. In the proportion of resources for amendments, the municipalities of group I (most vulnerable) had more participation, and those of group IV had less participation if compared to the allocation of the PAB-Fixo. The distribution of resources by the parliamentary amendment did not cover all municipalities, even the most vulnerable ones, i.e., belonging to groups I and II. There was great inequality of resources per capita according to the groups of municipalities. CONCLUSION: The parliamentary amendments distorted the model of equitable allocation of resources proposed by the Ministry of Health for the PAB-Fixo, by allocating resources in a much more significant proportion to the municipalities of group I and much less to those of group IV, which is in disagreement with this model. Furthermore, this distribution by amendments does not benefit all municipalities, not even the most vulnerable. |
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Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PABDistortions of parliamentary amendments to the equitable allocation of federal resources to the PABAlocação de Recursos para a Atenção à Saúde, legislação & jurisprudência Financiamento GovernamentalGastos Públicos com SaúdeDisparidades em Assistência à Saúde, economiaSistema Único de SaúdeHealth Care Rationing, legislation & jurisprudenceUnified Health SystemFinancing, GovernmentPublic Expenditures on HealthHealthcare Disparities, economicsOBJECTIVE: Analyze the implications of parliamentary amendments (EP) for the model of equitable allocation of resources from the Fixed Primary Care Minimum (PAB-Fixo) to municipalities in the period from 2015 to 2019. METHODS: A descriptive and exploratory study was conducted on allocating federal resources to the PAB-Fixo and on the increment in the PAB by parliamentary amendment. The municipalities were classified into four groups according to degrees of socioeconomic vulnerability defined by the Ministry of Health for the allocation of PAB-Fixo resources. The transfers from the Ministry by parliamentary amendment were identified. The proportions of municipalities benefiting per group were analyzed by resources allocated from the PAB-Fixo and increment to the minimum by EP. RESULTS: There were reduced resources allocated to the PAB-Fixo (from R$ 6.04 billion to R$ 5.51 billion, -8.8%) and increased increment to PAB by parliamentary amendment (from R$ 95.06 million to R$ 5.58 billion, 5.767%) between 2015 and 2019. The participation of municipalities by the group of those favored by EP was similar to that in the PAB-Fixo. In the proportion of resources for amendments, the municipalities of group I (most vulnerable) had more participation, and those of group IV had less participation if compared to the allocation of the PAB-Fixo. The distribution of resources by the parliamentary amendment did not cover all municipalities, even the most vulnerable ones, i.e., belonging to groups I and II. There was great inequality of resources per capita according to the groups of municipalities. CONCLUSION: The parliamentary amendments distorted the model of equitable allocation of resources proposed by the Ministry of Health for the PAB-Fixo, by allocating resources in a much more significant proportion to the municipalities of group I and much less to those of group IV, which is in disagreement with this model. Furthermore, this distribution by amendments does not benefit all municipalities, not even the most vulnerable.OBJETIVO: Analisar as implicações das emendas parlamentares (EP) para o modelo de alocação equitativa de recursos do Piso da Atenção Básica Fixo (PAB-Fixo) aos municípios no período de 2015 a 2019. MÉTODOS: Realizou-se um estudo descritivo e exploratório da alocação de recursos federais para o PAB-Fixo e para incremento ao PAB por emenda parlamentar. Os municípios foram classificados em quatro grupos, segundo graus de vulnerabilidade socioeconômica definidos pelo Ministério da Saúde para destinação de recursos do PAB-Fixo. Os repasses do ministério por emenda parlamentar foram identificados, analisando-se as proporções de municípios beneficiados em cada grupo por recursos alocados do PAB-Fixo e do incremento ao piso por EP. RESULTADOS: Verificou-se redução dos recursos alocados ao PAB-Fixo (de R$ 6,04 bilhões para R$ 5,51 bilhões, -8,8%) e aumento do incremento ao PAB por emenda parlamentar (de R$ 95,06 milhões para R$ 5,58 bilhões, 5.767%) entre 2015 e 2019. A participação dos municípios por grupo dos que foram favorecidos por EP foi semelhante à dos municípios do PAB-Fixo. Na proporção de recursos por emendas, os municípios do grupo I (mais vulneráveis) tiveram maior participação e os do grupo IV, menor participação, se comparada à alocação do PAB-Fixo. A distribuição de recursos por emenda parlamentar não contemplou todos os municípios, mesmo aqueles mais vulneráveis, pertencentes aos grupos I e II. Houve grande desigualdade de recursos per capita segundo os grupos de municípios. CONCLUSÃO: As emendas parlamentares distorceram o modelo de alocação equitativa de recursos proposto pelo Ministério da Saúde para o PAB-Fixo, ao destinar recursos em proporção muito maior para os municípios do grupo I e muito menor para os do grupo IV, o que está em desacordo com esse modelo, além disso essa distribuição por emendas não beneficia a todos os municípios, nem mesmo aos mais vulneráveis.Universidade de São Paulo. Faculdade de Saúde Pública2022-12-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/20615510.11606/s1518-8787.2022056004465Revista de Saúde Pública; Vol. 56 (2022); 123Revista de Saúde Pública; Vol. 56 (2022); 123Revista de Saúde Pública; v. 56 (2022); 1231518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/206155/189777https://www.revistas.usp.br/rsp/article/view/206155/189776https://www.revistas.usp.br/rsp/article/view/206155/189775Copyright (c) 2022 Fabiola Sulpino Vieira, Luciana Dias de Limahttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessVieira, Fabiola SulpinoLima, Luciana Dias de2022-12-21T21:49:00Zoai:revistas.usp.br:article/206155Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2022-12-21T21:49Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB Distortions of parliamentary amendments to the equitable allocation of federal resources to the PAB |
title |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB |
spellingShingle |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB Vieira, Fabiola Sulpino Alocação de Recursos para a Atenção à Saúde, legislação & jurisprudência Financiamento Governamental Gastos Públicos com Saúde Disparidades em Assistência à Saúde, economia Sistema Único de Saúde Health Care Rationing, legislation & jurisprudence Unified Health System Financing, Government Public Expenditures on Health Healthcare Disparities, economics |
title_short |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB |
title_full |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB |
title_fullStr |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB |
title_full_unstemmed |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB |
title_sort |
Distorções das emendas parlamentares à alocação equitativa de recursos federais ao PAB |
author |
Vieira, Fabiola Sulpino |
author_facet |
Vieira, Fabiola Sulpino Lima, Luciana Dias de |
author_role |
author |
author2 |
Lima, Luciana Dias de |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Vieira, Fabiola Sulpino Lima, Luciana Dias de |
dc.subject.por.fl_str_mv |
Alocação de Recursos para a Atenção à Saúde, legislação & jurisprudência Financiamento Governamental Gastos Públicos com Saúde Disparidades em Assistência à Saúde, economia Sistema Único de Saúde Health Care Rationing, legislation & jurisprudence Unified Health System Financing, Government Public Expenditures on Health Healthcare Disparities, economics |
topic |
Alocação de Recursos para a Atenção à Saúde, legislação & jurisprudência Financiamento Governamental Gastos Públicos com Saúde Disparidades em Assistência à Saúde, economia Sistema Único de Saúde Health Care Rationing, legislation & jurisprudence Unified Health System Financing, Government Public Expenditures on Health Healthcare Disparities, economics |
description |
OBJECTIVE: Analyze the implications of parliamentary amendments (EP) for the model of equitable allocation of resources from the Fixed Primary Care Minimum (PAB-Fixo) to municipalities in the period from 2015 to 2019. METHODS: A descriptive and exploratory study was conducted on allocating federal resources to the PAB-Fixo and on the increment in the PAB by parliamentary amendment. The municipalities were classified into four groups according to degrees of socioeconomic vulnerability defined by the Ministry of Health for the allocation of PAB-Fixo resources. The transfers from the Ministry by parliamentary amendment were identified. The proportions of municipalities benefiting per group were analyzed by resources allocated from the PAB-Fixo and increment to the minimum by EP. RESULTS: There were reduced resources allocated to the PAB-Fixo (from R$ 6.04 billion to R$ 5.51 billion, -8.8%) and increased increment to PAB by parliamentary amendment (from R$ 95.06 million to R$ 5.58 billion, 5.767%) between 2015 and 2019. The participation of municipalities by the group of those favored by EP was similar to that in the PAB-Fixo. In the proportion of resources for amendments, the municipalities of group I (most vulnerable) had more participation, and those of group IV had less participation if compared to the allocation of the PAB-Fixo. The distribution of resources by the parliamentary amendment did not cover all municipalities, even the most vulnerable ones, i.e., belonging to groups I and II. There was great inequality of resources per capita according to the groups of municipalities. CONCLUSION: The parliamentary amendments distorted the model of equitable allocation of resources proposed by the Ministry of Health for the PAB-Fixo, by allocating resources in a much more significant proportion to the municipalities of group I and much less to those of group IV, which is in disagreement with this model. Furthermore, this distribution by amendments does not benefit all municipalities, not even the most vulnerable. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12-07 |
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://www.revistas.usp.br/rsp/article/view/206155 10.11606/s1518-8787.2022056004465 |
url |
https://www.revistas.usp.br/rsp/article/view/206155 |
identifier_str_mv |
10.11606/s1518-8787.2022056004465 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/206155/189777 https://www.revistas.usp.br/rsp/article/view/206155/189776 https://www.revistas.usp.br/rsp/article/view/206155/189775 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2022 Fabiola Sulpino Vieira, Luciana Dias de Lima http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2022 Fabiola Sulpino Vieira, Luciana Dias de Lima http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf text/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 56 (2022); 123 Revista de Saúde Pública; Vol. 56 (2022); 123 Revista de Saúde Pública; v. 56 (2022); 123 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221803378900992 |