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"Gastos elevados na assistência médico-hospitalar de um plano de saúde" / A health insurance's high medical expendituresKanamura, Alberto Hideki 01 December 2005 (has links)
Administradores de saúde estão preocupados com a persistente elevação dos gastos com saúde. Um problema econômico, social e médico. Objetivando estudar as características das pessoas que produzem gastos elevados com saúde, tomou-se a população de um plano de saúde, identificou-se 1% dos casos que mais gastaram com assistência médico-hospitalar e analisou-se a distribuição por idade, sexo, natureza dos gastos, diagnósticos e o impacto no custo do plano. Os resultados revelaram que a idade é importante fator associado ao gasto elevado, que materiais e medicamentos constituíram a maior fração do gasto e os diagnósticos associados mais freqüentes foram doenças do aparelho circulatório e neoplasias malignas. A fração selecionada de 1% foi responsável por 36,2% da despesa e gastaram em média 56,3 vezes mais que os demais / Healthcare managers are concerned with the persistent increasing of healthcare expenditure. An economics, social and medical problem. The objective of this study was to know the characteristics of the population that could predict high medical expenditure. It was selectec the 1% of customers (assisted by an healthcare plan) that generated the highest expenditures. The distribution by age, sex, kind of expenditure, diagnoses and the impact in insurance cost were analyzed. The results showed that the age is important associated factor, medical supplies and drugs were mainly responsible for expenditure. The main diagnose associated with high expenditure were circulatory diseases and cancer was the second. The 1% selected customers generated 36.2% of the total expenditure of their healthcare plan, and spent 56.3 times more than others customers, on average
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Essays on the macroeconomic consequences of remittances in developing countriesEbeke, Christian Hubert Xavier Camille 24 June 2011 (has links) (PDF)
This thesis focused on the consequences of remittance inflows in developing countries. The first partexplored the causal impacts of remittances on some indicators of aggregate welfare while the secondpart examined the effects of remittances on public policy. Several results emerged. First, remittanceinflows help reduce the proportion of individuals selling low wages and this effect is stronger in acontext of low level of financial development, high macroeconomic instability and less unpredictableremittances (Chapter 1). Second, remittances have a robust stabilizing impact on the privateconsumption. However, this effect tends to decrease with the levels of remittance inflows and financialdevelopment. Moreover, remittance-dependent economies seem to be strongly sheltered against thedamaging effects of various types of shocks affecting consumption (Chapter 2). In Chapter 3, theresults highlighted that remittance inflows dampen the positive effect of natural disasters on the outputgrowth volatility. However, this impact was strongly reduced as the level of remittances increased.The second part of the thesis revealed interesting results regarding the effects of remittance inflows onpublic policy. First, remittance inflows reduce the insurance role played by the governmentconsumption in more open economies and this effect is more likely to hold when remittances exhibit acountercyclical behavior (Chapter 4). In Chapter 5, the results showed that the fiscal retrenchmentinduced by remittance inflows, is particularly marked for the public education and health spending incountries characterized by various types of governance problems. Finally, the thesis showed that theeffects of remittances do not only concern the expenditure side but also the revenue side. Remittancesare more likely to increase the fiscal space in receiving economies that rely on the value added taxsystem. In these countries, remittance inflows help increase both the level and the stability of thegovernment tax revenue ratio (Chapter 6).
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The Role Of Politics And Instability On Public Spending Dynamics And Macroeconomic Performance: Theory And Evidence From TurkeyIsmihan, Mustafa 01 December 2003 (has links) (PDF)
This Ph.D. thesis comprises of two parts. Part I develops a framework to provide insights into the understanding of several political macro-economy issues related to fiscal policy making. This framework links the overall macroeconomic performance to the public spending and borrowing decisions. The key feature of this framework is that it makes a distinction between productive (e.g. public investment) and non-productive public spending (e.g. popular spending). It is shown that a high level of political instability may lead to myopic and populist policies and may be associated with less favorable macroeconomic performance in terms of not only future output and inflation but also future popular spending. Part I also suggests an alternative channel for expansionary or Non-Keynesian fiscal contractions based on the productivity enhancing role of productive public spending. It is shown that if the incumbent government reduces popular (productive) spending rather than productive (popular) spending, then Non-Keynesian (Keynesian) effects are achieved. Furthermore, it is shown that the favorable effects of public investment depends positively on its quality in this framework. Moreover, the net effect of productive spending financed by borrowing on the next period' / s macroeconomic performance depends on the benefits of productive spending relative to the costs of borrowing. Even under a capital borrowing rule higher public investment may yield unfavorable effects and also it may not necessarily prevent the strategic use of public investment, even though it prevents strategic debt accumulation. Part II investigates the effects of macroeconomic instability on capital accumulation and economic growth in the Turkish economy over the 1963-1999 period. Descriptive and econometric (time series) analyses suggest that macroeconomic instability not only deters capital accumulation and economic growth but it may also reverse the complementarity between public and private investment in the long-run.
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Análise do custo-aluno das creches municipais diretas do município de Santo AndréCarmo, João Adolfo do, Santos, Marinella Burgos Pimentel dos 26 November 2014 (has links)
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Previous issue date: 2014-11-26 / The present study analysed the cost of a child care student in nursery schools specialized on the first stage of early childhood education, which includes children between 0-3 years old. It responds to the problem situation presented by the Education Department of the Municipality of Santo André (SP), characterized by the need for improving the management of financial resources in an environment of budgetary difficulties and increasing demand. Twelve nursery schools directed managed by the municipality with care exclusive to children in this age group were selected. The methodology was based on the Municipal Government Budget Information System, and was performed aiming to define the cost components of the case using the absorption costing method. Additionally, the administrative processes related to the costs components were analyzed and many actors involved in the direct process of management and from others departments were interviewed. In addition, experiences reported by academics experts in costs in the public sector supported the research and analysis. The study found an annual average cost of R$ 11,970.72 per student. According to the number of students the nursery schools units were grouped into three categories: i) small: up to 149 students (three units); ii) medium: between 150 and 190 students (five units); and, iii) large: over 190 students (four units). The conclusions were that large nursery schools had advantage compared to the others, with an average cost student of R$ 11,684.03, followed by mediumsized nurseries, R$ 11,751.46 per student and small units size, which presented a cost of R$ 13,235.88/per student, which means a cost 13.23% higher than the large schools. These results indicate the existence of scale economy according to the size of the nursery school and can support the managers decision-making for future expansion projects of the public nursery schools. / O presente estudo tem como foco o levantamento e análise do custo-aluno das creches, primeira etapa da Educação Infantil, que compreende as crianças de 0 a 3 anos de idade. Ele responde à situação problema apresentada pela Secretaria de Educação do Município de Santo André (SP), caracterizada pela necessidade do aprimoramento da gestão dos recursos financeiros em um cenário de dificuldades orçamentárias e aumento de demanda. Foram selecionadas 12 unidades municipais da rede direta, com atendimento exclusivo a crianças nesta faixa etária. A metodologia utilizada teve como base a utilização do Sistema de Informações do Orçamento Público municipal, a partir do qual foram realizadas as consultas e definições dos componentes do custo do objeto em estudo, sendo que a metodologia de acumulação de custos utilizada foi o custeio por absorção. Adicionalmente, os autores analisaram os processos administrativos relacionados aos itens de custeio e realizaram entrevistas com os diversos atores envolvidos nos processos de gestão daquela e de outras secretarias, bem como acadêmicos dedicados ao estudo de custos no setor público, cujas experiências relatadas subsidiaram a pesquisa e as avaliações realizadas. O estudo apontou um custo-aluno médio de R$ 11.970,72 sendo que, para melhor análise dos resultados, as unidades escolares foram agrupadas em três categorias de acordo com o número de alunos: i) pequeno porte: com até 149 alunos (três unidades); ii) médio porte: entre 150 e 190 alunos (cinco unidades); e, iii) grande porte: com mais de 190 alunos (quatro unidades). A partir dessa divisão foi possível concluir que as creches de grande porte apresentaram vantagem comparativa em relação às demais, com custo-aluno médio de R$ 11.684,03, seguidas das creches de médio porte, R$ 11.751,46 e pelas unidades de pequeno porte, que apresentaram o custo-aluno de R$ 13.235,88, ou seja, 13,23% acima das escolas de grande porte. Esses resultados indicam a existência de ganhos de escalas de acordo com o porte da creche e pode subsidiar a tomada de decisão dos gestores para futuros projetos de expansão da rede pública de creches.
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Recursos financeiros descentralizados para a escola pública: uma política necessária / Decentralizing financial resources to public schools: a necessary policyMariana Peleje Vianna 29 October 2015 (has links)
O estudo buscou realizar pesquisas teórica, legal-financeira e empírica sobre os recursos financeiros descentralizados que são transferidos diretamente às escolas públicas municipais de São Paulo, pelos governos federal (Programa Dinheiro Direto na Escola, PDDE) e municipal (Programa de Transferência de Recursos Financeiros, PTRF, e Verba de Adiantamento), investigando sobre os procedimentos legais, administrativos e participativos que envolvem a gestão destes recursos, de forma a apresentar dados quantitativos e qualitativos sobre eles, tendo como amostra de pesquisa cinco escolas de diferentes modalidades de ensino: um Centro de Educação Infantil (CEI), uma Escola Municipal de Educação Infantil (EMEI), uma Escola Municipal de Ensino Fundamental (EMEF), um Centro Integrado de Educação de Jovens e Adultos (CIEJA) e uma Escola Municipal de Educação Básica para Surdos (EMEBS). A dimensão empírica da pesquisa se dividiu em duas subdimensões: macro e micro. A dimensão empírica macro se deu numa perspectiva legal-financeira, pesquisando sobre as origens e os procedimentos legais dos programas que transferem recursos financeiros descentralizados às escolas públicas, suas normas de utilização, movimentação e prestação de contas. Essa dimensão também buscou desenvolver uma série histórica, contemplando o período de 2007 a 2013, a qual compara os montantes dos recursos financeiros descentralizados transferidos anualmente às escolas municipais de São Paulo com o orçamento total anual da educação do município, objetivando demonstrar o quanto estes programas representam em termos percentuais para o planejamento orçamentário municipal. A dimensão empírica micro da pesquisa se deu a partir da verificação em campo, no âmbito das escolas pesquisadas, levantando suas dificuldades e avanços em lidar com os recursos financeiros transferidos, trazendo dados sobre seus montantes e aplicações anuais (2007 a 2013), a partir da verificação dos documentos de prestação de contas das Associações de Pais e Mestres (APMs), de instrumentos de entrevista e de levantamento de dados, especificamente elaborados pelos métodos da pesquisa. Os dados e as informações apresentados abordam questões importantes sobre financiamento e gestão financeira escolar, tendo o intuito de contribuir para o debate sobre políticas públicas de gestão financeira escolar e fornecer subsídios que possam compor estudos cujo objetivo seja uma abordagem sobre a realidade financeira das escolas públicas e a gestão democrática de seus recursos financeiros, com vistas à melhoria da qualidade de ensino. / The study sought to carry out theoretical, legal-financial and empirical research on the decentralized financial resources that are transferred directly to public schools in São Paulo, by the federal government (\"Direct Money to School Program\", PDDE) and by the municipal government (\"Financial Resources Transfer Program\", PTRF, and \"Verba de Adiantamento\"), investigating on the legal, administrative and participatory procedures that involve the management of these resources in order to provide quantitative and qualitative data about them. As a research sample there were five schools of different types of education modalities: one Early Childhood Center (CEI), a Municipal School of Early Childhood Education (EMEI), a Municipal Elementary School (EMEF), an Integrated Centre for Youth and Adult Education (CIEJA) and a Municipal Basic Education School for the Deaf ( EMEBS). The empirical dimension of the research is divided into two sub-dimensions: macro and micro scales. The macro empirical dimension was given a legal and financial perspective, researching the origins and legal procedures of the programs that transfer decentralized financial resources to public schools, their rules of use, handling and accountability. This dimension also sought to develop a historical series, covering the period 2007 to 2013, which compares the amounts of decentralized resources transferred annually to public schools in São Paulo with the total annual budget of the municipality\'s education, aiming to show how much (in percentage) these programs represent in terms of the municipal budget planning. The micro scale empirical research took place from the field verification, along with the surveyed schools, raising their difficulties and advances in dealing with the financial resources transferred to them, bringing data on their amounts and annual applications (2007 - 2013), from verification of the accounting documents of the Parent Teacher Associations (APMs), interview and data collection tools, specifically designed by the methods of the research. The data and information presented address important matters about funding and school financial management, with the aim of contributing to the debate on public policies to school financial management and provide subsidies that can compose studies whose aim is the approach to the financial reality of public schools and democratic management of its financial resources, looking forward to improving the quality of education.
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As relações entre economia e política: uma análise dos ciclos político-econômicos nos estados brasileiros no período de 1995 a 2008Araujo, Jevuks Matheus de 22 February 2010 (has links)
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Previous issue date: 2010-02-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The objective of this study is to analyze the political-economic cycles in the Brazilian
states from 1995 to 2008. The hypothesis that was considered was that the cyclical
behavior in public spending caused by politically motivated election and / or party.
The theoretical framework used was developed originally in the work of Downs
(1957) and Nordhaus (1975). The assumptions of the model of political opportunism
and Hibbs (1977) the assumptions of the model party. In the 80s of last century, the
work of Alesina (1987) and Roggof and Sibert (1988) incorporated the original
models the concepts of rational expectations and asymmetric information. Was made
a econometric tests to check the influence of the electoral calendar and the party
ideology on the conduct of public spending. The econometric model was used panel
data GMM estimator with dynamic system. The results showed that the state
increase spending in election years and is set down in post-election years, showing
an opportunistic behavior by governments. The results also showed the expenditures
implemented by the governments of different party ideologies had different
behaviors, left-wing parties promote further expansion of public spending. The
completion of the work is in the process of choosing the state public expenditures are
both political and partisan cycles. / O objetivo deste trabalho é analisar os ciclos político-econômicos nos estados
brasileiros no período de 1995 a 2008. Foi considerada hipótese de existência de
comportamento cíclico nos gastos públicos ocasionados por motivações políticas
eleitoreiras e/ou partidárias. O marco teórico utilizado foi desenvolvido
originariamente nos trabalhos de Downs (1957), Nordhaus (1975) e Hibbs (1977) os
dois primeiros estabeleceram pressupostos do modelo de oportunismo político e o
terceiro instituiu os pressupostos do modelo partidário. Na década de 80 do século
passado, os trabalhos de Alesina (1987) e Roggof e Sibert (1988) incorporaram aos
modelos originais os conceitos de expectativas racionais e assimetria de
informação. A partir das referências teóricas foram aplicados testes econométricos
para verificar a existência de influência do calendário eleitoral e da ideologia
partidária sobre o comportamento dos gastos públicos. O modelo econométrico
utilizado foi de dados em painel dinâmico com estimador MGM Sistema. Os
resultados das estimações demonstram que os gastos públicos estaduais aumentam
em anos eleitorais e se ajustam em anos pós-eleitorais, evidenciando um
comportamento oportunista por parte dos governantes. Os resultados também
demonstraram que os gastos executados por governos de ideologias partidárias
diferentes apresentam comportamentos diferentes, partidos de esquerda promovem
uma maior expansão dos gastos públicos. A conclusão do trabalho é que no
processo de escolha dos gastos público estadual há simultaneamente ciclos
políticos e partidários.
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Dust of ideas in the wind ou como pequenos grãos de ideias se propagam: o impacto do ambiente internacional e as pressões internas sobre o padrão na oferta de políticas públicas no Brasil e na Colômbia / Dust of ideas in the wind or as a grain of ideas propagate: the impact of the international environment and internal pressures on in the supply of public policies in Brazil and ColombiaCosta, Saulo Felipe 24 May 2011 (has links)
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Previous issue date: 2011-05-24 / CAPES / The research aimed to screen for evidence of the influence of ideals of the
international medium on the pattern of public policies in Brazil and Colombia. Through
an approach that linked the theory of two levels games and policy paradigm
understanding in Kuhn and the mechanism of social learning, it was possible to develop
a proxy for the degree of influence of international pressure for the adoption of a given
policies. We attempted to analyze the influence of the proposed of solution to the state
problems, issued by multilateral agencies, through what became known as the
Washington Consensus. The choice of Brazil was due to an increased availability of
data, while the choice of Colombia is its function in this country experience a long
period of democratic rule, with jarring ideological profile of the Brazilian. For this, the
research has focused on the behavior of public spending in both countries, was also
performed a more specific case study on the deployment of the managerial model of
public administration in Brazil, with the aim of better understanding how this process
occurred import and export of ideas and solutions for different problems. The research
showed that multilateral organizations have greater power to print your ideas in
countries' policies when such changes are first and second order, by type built. In return,
changes in third order are only induced by multilateral bodies, since the ideology of
society plays a more decisive role for the incorporation or not of such ideas
"exogenous”. / A pesquisa em tela buscou por evidências da influência de ideais do meio
internacional sobre o padrão de oferta de políticas públicas no Brasil e na Colômbia.
Através de uma abordagem que uniu a teoria dos jogos de dois níveis à compreensão de
mudança de paradigma em Kuhn e ao mecanismo de aprendizagem social (social
learning), foi possível elaborar uma proxy para o grau de influência das pressões
internacionais pela adoção de determinado conjunto de políticas. Buscou-se analisar a
influência das propostas de solução aos problemas estatais, emanadas por agências
multilaterais, através do que ficou conhecido como Consenso de Washington. A escolha
do Brasil se deu devido uma maior disponibilidade de dados, ao passo que a opção pela
Colômbia se deu em função deste país experimentar um longo período democrático,
com perfil ideológico destoante do brasileiro. Para tanto, a pesquisa se debruçou sobre o
comportamento do gasto público em ambos os países, foi executado também um estudo
de caso mais específico sobre a implantação do modelo gerencial de administração
pública no Brasil, com o intuito de melhor compreender como se deu este processo de
importação e exportação de ideais e soluções para os mais diversos problemas. A
pesquisa evidenciou que os organismos multilaterais possuem um maior poder de
imprimir seu ideário nas políticas dos países quando tais mudanças são de primeira e de
segunda ordem, segundo a tipologia construída. Em contra partida, mudanças de terceira
ordem são susceptíveis apenas de indução pelos organismos multilaterais, uma vez que
a ideologia da sociedade desempenha um papel mais determinante para a incorporação
ou não de tal ideário “exógeno”.
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"Gastos elevados na assistência médico-hospitalar de um plano de saúde" / A health insurance's high medical expendituresAlberto Hideki Kanamura 01 December 2005 (has links)
Administradores de saúde estão preocupados com a persistente elevação dos gastos com saúde. Um problema econômico, social e médico. Objetivando estudar as características das pessoas que produzem gastos elevados com saúde, tomou-se a população de um plano de saúde, identificou-se 1% dos casos que mais gastaram com assistência médico-hospitalar e analisou-se a distribuição por idade, sexo, natureza dos gastos, diagnósticos e o impacto no custo do plano. Os resultados revelaram que a idade é importante fator associado ao gasto elevado, que materiais e medicamentos constituíram a maior fração do gasto e os diagnósticos associados mais freqüentes foram doenças do aparelho circulatório e neoplasias malignas. A fração selecionada de 1% foi responsável por 36,2% da despesa e gastaram em média 56,3 vezes mais que os demais / Healthcare managers are concerned with the persistent increasing of healthcare expenditure. An economics, social and medical problem. The objective of this study was to know the characteristics of the population that could predict high medical expenditure. It was selectec the 1% of customers (assisted by an healthcare plan) that generated the highest expenditures. The distribution by age, sex, kind of expenditure, diagnoses and the impact in insurance cost were analyzed. The results showed that the age is important associated factor, medical supplies and drugs were mainly responsible for expenditure. The main diagnose associated with high expenditure were circulatory diseases and cancer was the second. The 1% selected customers generated 36.2% of the total expenditure of their healthcare plan, and spent 56.3 times more than others customers, on average
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Composition des dépenses publiques et impacts sur la croissance économique : analyses théoriques et empiriques sur des panels de pays développés, émergents et en voie de développement / Composition of public spending and impacts on economic growth : theoretical and empirical analyses on panels of developed, emerging and developing countriesDione, Léon-Amath 28 September 2016 (has links)
Le rôle économique de l’État fait l’objet de nombreuses controverses autant dans le cadre théorique que du point de vue pratique. Les acteurs de ces controverses sont les objecteurs de l’efficacité de l’intervention publique depuis Smith à nos jours, les keynésiens et les économistes de la synthèse néo-classique. Divers thèmes allant du principe de la main invisible, de l’impôt, des anticipations, du fardeau de la dette, de l’effet d’éviction, de la production de biens publics sont questionnés à travers de tels débats. Le travail explique la ventilation des composantes des dépenses publiques et leurs conséquences suivant le développement (OCDE, BRICS et UEMOA). L’étude montre également que les effets des dépenses publiques et de leurs composantes sur l’activité économique sont différents suivant le niveau de revenu des pays. Enfin, ce travail de recherche suggère que la taille optimale des dépenses publiques et celle de leurs composantes sont une fonction croissante du niveau de développement à l’exception des dépenses militaires. / The economic role of the State has been the subject of much debate both from theoretical and the practical perspectives. The actors of these controversies include the objectors of the efficiency of the public intervention since Smith to the present days, Keynesians and economists of the synthesis. Topics ranging from principle of the invisible hand, tax, expectations, burden of the debt, crowding out effect, public sector production are treated through of such debates. The work explains the breakdown of public spending components and implications for countries at levels development (OECD, BRICS, and WAEMU). The study also indicated that the effects of the public spending and its components on the economic activity are different according countries’ stage of development. A lastly, research work suggests that the optimal size of the public spending and its components are an increasing function of the level of development with the exception of military expenditures.
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Ciclos Políticos en Procesos Electorales Regionales Peruanos / Budget Cycle in The Peruvian Regional ElectionsLópez Guzmán, Diego Alejandro 04 November 2021 (has links)
La investigación realizada en este documento tiene como objetivo demostrar la existencia de ciclos políticos en los procesos electorales de los gobiernos regionales peruanos, durante los años 2007 – 2018, con una temporalidad mensual y basándose en el modelos teórico de Shi y Sevensson (2006). De esta manera, para poder confirmar la hipótesis planteada se utiliza un modelo panel de efectos fijos.
La principal conclusiones a las que se este documento llego son: Primero, la confirmación de la existencia de ciclos políticos marcados alrededor de las fechas de los procesos electorales de los gobiernos regionales peruanos y segundo, la confirmación de la importancia de realizar este tipo de estudios de manera mensual. / The investigation realized in this document have the objective of demonstrated the existence of budget cycle in the Peruvian reginal elections during the period 2007 - 2018 with a monthly temporality and it has been based in the theorical model of Shi and Sevensson (2006). In this way, to demonstrate this hypothesis this investigation uses a panel model with Fixed Effects Regression.
The main conclusions that this document have are: First, the confirmation of the existence of the marked Budget Cycles around the date of the Peruvian regional elections and second, the confirmation of the relevance in the use of monthly temporality in studies of this type. / Trabajo de investigación
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