Submitted by PPG Economia do desenvolvimento (economia-pg@pucrs.br) on 2017-12-12T17:00:04Z No. of bitstreams: 1 JORGE_LUIS_TONETTO_DIS.pdf: 2973041 bytes, checksum: eb8a94f5e93cbbed89b22017d14fbb38 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-12-19T11:23:30Z (GMT) No. of bitstreams: 1 JORGE_LUIS_TONETTO_DIS.pdf: 2973041 bytes, checksum: eb8a94f5e93cbbed89b22017d14fbb38 (MD5) / Made available in DSpace on 2017-12-19T11:26:39Z (GMT). No. of bitstreams: 1 JORGE_LUIS_TONETTO_DIS.pdf: 2973041 bytes, checksum: eb8a94f5e93cbbed89b22017d14fbb38 (MD5) Previous issue date: 2017-11-20 / This research was directed at health economics, seeking to verify if municipal public health expenditures have an influence on the variation of the health indicators of each municipality, specifically in the indicators IFDM-Health (Firjan Index of Municipal Development) and Potential Years of Lost Life. First, there was a broad review of the national and international literature, with emphasis on the regulatory framework, health expenditures, financing models and efficiency. The period analyzed was from 2005 to 2014 for the Potential Years of Lost Lifeand from 2005 to 2013 for the IFDM-Health. All Brazilian municipalities that had available indicators were analyzed, and the Potential Years of Lost Lifewere calculated for each municipality per year, with the limit of 70 years as a potential life. The expenditures data of the municipalities were extracted from the National Treasury Secretariat and were inflated by the IPCA until 2014. The databases of IBGE, Datasus and SNIS were also used. This basis was adequate to its nomenclature and worked to be used in an econometric program for panel analysis. Four models were developed, two for each dependent variable, differentiated by the use of the health function and alternatively by the sub-functions of basic care and hospital care. The results pointed in different directions. For all models, analyzing the periods of each management over time, suggests an improvement in efficiency. Population size has significance for the variable Potential Years of Lost Life, and the municipal expenditure function was also significant in the quadratic and cubic forms, and only the basic care subfunction showed to be relevant, allowing an optimal point to be determined, from where the efficiency process started. For the IFDM-Health, the variable physicians was significant and the signal as expected. The municipal expenditures on the health function were also relevant in the quadratic form, indicating a point where it becomes inefficient. In health subfunctions expenditures, it was possible to find an optimization point for both. / Esta pesquisa foi direcionada a economia da sa?de, buscando verificar se os gastos de sa?de p?blicos municipais t?m influ?ncia na varia??o dos indicadores de sa?de de cada munic?pio, especificamente nos indicadores IFDM-Sa?de (?ndice Firjan de Desenvolvimento Municipal) e Anos potenciais de vida perdido (APVP). Primeiramente foi realizada ampla revis?o da literatura nacional e internacional, com ?nfase no marco regulat?rio, nos gastos em sa?de, nos modelos de financiamento e no quesito efici?ncia. A despesa em sa?de em geral tem aumentado sua relev?ncia nos or?amentos, incluindo gastos p?blicos e privados. A busca pela efici?ncia tem pautado a maioria dos pa?ses. O per?odo analisado foi de 2005 a 2014 para o APVP e de 2005 a 2013 para o IFDM-Sa?de. Foram analisados todos os munic?pios brasileiros que possu?am indicadores dispon?veis, e para o APVP foi calculado para cada munic?pio por ano, tendo como limite 70 anos como potencial de vida. Os dados de gasto dos munic?pios foram extra?dos da Secretaria do Tesouro Nacional e foram inflacionados pelo IPCA at? 2014. Utilizou-se ainda as bases do IBGE, do Datasus e do SNIS. Essa base foi adequada a sua nomenclatura e trabalhada para ser utilizada em programa econom?trico para an?lise em painel. Foram desenvolvidos quatro modelos, dois para cada vari?vel dependente, diferenciados pelo uso da fun??o sa?de e alternativamente pelas subfun??es aten??o b?sica e assist?ncia hospitalar. Os resultados apontaram em diferentes dire??es. Para todos os modelos, analisado os per?odos de cada gest?o ao longo do tempo, sugere uma melhora na efici?ncia. O tamanho populacional tem signific?ncia para a vari?vel APVP, e o gasto municipal na fun??o sa?de se mostrou significante tamb?m nas formas quadr?ticas e c?bicas, e apenas a subfun??o aten??o b?sica mostrou-se relevante, permitindo apurar um ponto de otimiza??o, a partir de onde inicia-se processo de efici?ncia. Para a vari?vel IFDM-Sa?de mostrou-se significante a vari?vel m?dicos e com sinal esperado. Quanto aos gastos municipais na fun??o sa?de, este foi relevante tamb?m na forma quadr?tica, indicando ponto onde torna-se ineficiente. Nas subfun??es sa?de foi poss?vel encontrar ponto de otimiza??o para ambas.