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Previous issue date: 2015-03-13 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The health care financing consists of a structural and structuring element that underpins economic social practices that take care of human life. Considering the importance of funding the conduct, implementation and success of health policies, this work aimed to analyze the Public Expenditure of the Unified National Health System (SUS) in the state of Bahia, from 2009 to 2012. It is a quantitative study of a descriptive and analytical perspective, comparative and retrospective, covering all 417 municipalities in Bahia. The main data on funding for the health sector were declared by municipalities to Information System Public Health Budgets (SIOPS), collected between 2013 and 2014, and tabulated with the help of the National Health Accounts model (National Health Accounts - NHA), specifically using the Table 1 (Funding Sources for Finance Professionals), which was adapted to the reality of funding and Brazilian information systems. The results revealed that in Bahia public spending on the SUS, accumulated over four years of study, was about R$ 29,23 billion, 30% of which (8,66 billion) for the year 2012. In considering only the resources declared by municipalities to SIOPS, expended by the three spheres of government, there was an increase of 50,58% in the Public Expenditure on Health (GPS), totaling in the period from R$ 17,105 billion. The macro-East draws attention to the large volume of spending, surpassing the mark of R$ 1 billion every year, and two of its health regions, Salvador and Cama?ari, have been in the GPS ranking apex in the period. The health expenditure by size analysis showed that the vast majority of municipalities, about 70% did not reach the level of R$ 5 million. It was found in 2010 that 20% of resources, about R$ 410,30 million, were transferred to the 219 municipalities with the lowest Municipal Human Development Index (IDHM) the state, on the other hand, the 37 cities with the best IDHM received approximately 60% of federal funds, that is, more than R$ 1,23 billion. It was evident also that 30% of resources, approximately R$ 615,45 million, was allocated to 40% of the population, which is spread over 348 municipalities of the total of 417 present in Bahia and 50%, equivalent to more than R$ 1 billion, were also transferred to 40% of the population, but that is distributed in only 17 municipalities. With regard to the volume of federal funds specifically for the Mobile Emergency Service (SAMU), from 2009 to 2012, noted an increase of 148,31%, highlighting the East macro-region. However, half of the state health regions did not show whether spending records with this service. The relative share of SAMU as Average funding block component and high complexity grew in the period, reached 6,67% in 2012. Data analysis identified the existing inequalities in the distribution of resources among regions, health regions and municipalities in the state of Bahia, but also inequalities, as municipalities and regions were favored already privileged socioeconomic at the expense of locations where populations are greater risks of illness and death, which remained being contemplated with proportionally fewer resources in relation to their health needs. It is not intended to generalize these results, but it is expected this study to contribute in the formulation of health policy, planning and management of resources within the SUS. / O financiamento da aten??o ? sa?de consiste em um elemento estrutural e estruturante que alicer?a economicamente as pr?ticas sociais que cuidam da vida humana. Considerando a import?ncia do financiamento na condu??o, na execu??o e no ?xito das pol?ticas de sa?de, esta disserta??o teve como objetivo analisar o Gasto P?blico do Sistema ?nico de Sa?de (SUS) no estado da Bahia, no per?odo de 2009 a 2012. Trata-se de um estudo quantitativo do tipo descritivo-anal?tico, comparativo e retrospectivo, que abrangeu todos os 417 munic?pios baianos. Os principais dados acerca dos recursos financeiros destinados ao setor sa?de foram declarados pelos munic?pios ao Sistema de Informa??es sobre Or?amentos P?blicos em Sa?de (SIOPS), coletados entre 2013 e 2014, e tabulados com o aux?lio do modelo de Contas Nacionais de Sa?de (National Health Accounts ? NHA), especificamente com uso a Tabela 1 (Fontes de Financiamento por Agentes de Financiamento), que foi adaptada ? realidade do financiamento e dos sistemas de informa??o brasileiros. Os resultados revelaram que na Bahia o gasto p?blico com o SUS, acumulado nos quatro anos de estudo, foi de cerca de R$ 29,23 bilh?es, sendo 30% deste total (8,66 bilh?es) referentes ao ano de 2012. Ao considerar apenas os recursos declarados pelos munic?pios ao SIOPS, dispendidos pelas tr?s esferas de governo, verificou-se um crescimento de 50,58% no Gasto P?blico em Sa?de (GPS), totalizando no quadri?nio R$ 17,105 bilh?es. A macrorregi?o Leste chama aten??o pelo grande volume de gasto, ultrapassando a cifra de R$ 1 bilh?o em todos os anos, sendo que duas de suas regi?es de sa?de, Salvador e Cama?ari, estiveram no ?pice do ranking de GPS, no per?odo. A an?lise por porte de gasto em sa?de mostrou que a grande maioria dos munic?pios, cerca de 70%, n?o alcan?ou o patamar dos R$ 5 milh?es. Constatou-se, em 2010, que 20% dos recursos, cerca de R$ 410,30 milh?es, foram transferidos para os 219 munic?pios com os menores ?ndices de Desenvolvimento Humano Municipal (IDHM) do estado; por outro lado, os 37 munic?pios com os melhores IDHM, receberam, aproximadamente, 60% dos recursos federais, isto ?, mais de R$ 1,23 bilh?es. Evidenciou-se tamb?m que 30% dos recursos, em torno de R$ 615,45 milh?es, foi destinado a 40% da popula??o, que se encontra espalhada por 348 munic?pios do total de 417 presentes na Bahia e 50%, o equivalente a mais de R$ 1 bilh?o, foram transferidos tamb?m para 40% da popula??o, mas que se distribui por apenas 17 munic?pios. No que concerne ao volume de recursos federais destinados especificamente para o Servi?o de Atendimento M?vel de Urg?ncia (SAMU), de 2009 a 2012, notou-se um aumento de 148,31%, com destaque para a macrorregi?o Leste. Todavia, metade das regi?es de sa?de do estado n?o apresentou sequer registros de gasto com esse servi?o. A participa??o relativa do SAMU como componente do bloco de financiamento de M?dia e Alta Complexidade cresceu no per?odo, atingido 6,67%, em 2012. A an?lise dos dados permitiu identificar desigualdades existentes na distribui??o dos recursos entre macrorregi?es, regi?es de sa?de e munic?pios do estado da Bahia, e tamb?m iniquidades, uma vez que foram favorecidos os munic?pios e regi?es privilegiados socioeconomicamente, em detrimento das localidades onde as popula??es encontram maiores riscos de adoecer e morrer, as quais permaneceram sendo contempladas com recursos proporcionalmente menores em rela??o ?s suas necessidades de sa?de. N?o se pretende generalizar esses resultados, mas se espera com este estudo poder contribuir nos processos de formula??o da pol?tica de sa?de e de planejamento e gest?o dos recursos no ?mbito do SUS.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.uefs.br:8080:tede/419 |
| Date | 13 March 2015 |
| Creators | Teles, Andrei Souza |
| Contributors | Coelho, Thereza Christina Bahia |
| Publisher | Universidade Estadual de Feira de Santana, Mestrado Acad?mico em Sa?de Coletiva, UEFS, Brasil, DEPARTAMENTO DE SA?DE |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da UEFS, instname:Universidade Estadual de Feira de Santana, instacron:UEFS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -2122225376607208326, 600, 600, 600, 600, 1006395569471477890, -6173167103754495199, 1802873727776104890 |
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