A methodology for apportioning federal SUS resources: the health needs index
ABSTRACT OBJECTIVE To present a methodology for apportioning Union resources to the federative units (FU – 26 states and one federal district) within the Brazilian Unified Health System (SUS) based on health needs measured by demographic, socioeconomic, epidemiological and geographical dimensions....
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2020-08-01
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| Series: | Revista de Saúde Pública |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100255&tlng=en |
| _version_ | 1798015270643564544 |
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| author | Áquilas Mendes Marcel Guedes Leite Leonardo Carnut |
| author_facet | Áquilas Mendes Marcel Guedes Leite Leonardo Carnut |
| author_sort | Áquilas Mendes |
| collection | DOAJ |
| description | ABSTRACT OBJECTIVE To present a methodology for apportioning Union resources to the federative units (FU – 26 states and one federal district) within the Brazilian Unified Health System (SUS) based on health needs measured by demographic, socioeconomic, epidemiological and geographical dimensions. METHODS The apportionment methodology proposal prioritizes the health needs axis, based on Law 141/2012. We adopted a proxy of needs that measures relative inequalities between, socioeconomic, geographic demographic and epidemiological conditions of the populations of the Brazilian Federative Units (FU) for 2015. We first used an adjustment so that the populations of the 27 FU are corrected by their relative needs regarding age and gender. To calculate the health needs axis, the multivariate techniques factorial analysis and principal components were used, and, based on such correction, we applied the health needs index. Subsequently, this index was applied to simulate the resources that should be transferred by the Ministry of Health to states in 2015. RESULTS As we made the methodological choice of transferring a single per capita amount to all states, so the proposal required population correction. Thus, in the analysis of health needs, the FUs that had their population corrected by a factor higher than the national average because of their greater relative need, were the states of: Maranhão, Piauí, Alagoas, Paraíba, Ceará, Pará, Bahia, Acre, Pernambuco, Rio Grande do Norte, Sergipe, Amazonas, Tocantins and Roraima. For the simulation aggregating all the financing blocks, without reducing the resources already distributed to the remaining states in 2015, indicated the additional need of R$ 4.6 billion. CONCLUSIONS The proposal addresses the absence of studies presenting quantitative simulations of federal resources distribution within the scope of SUS to the FUs, based on the apportionment criteria defined by Law 141/2012, in order to contribute to the reduction health inequalities and mitigate the effects of the economic crisis. |
| first_indexed | 2024-04-11T15:31:47Z |
| format | Article |
| id | doaj.art-d2a4414bcc6a441e9a63bf783a192e2d |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-04-11T15:31:47Z |
| publishDate | 2020-08-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-d2a4414bcc6a441e9a63bf783a192e2d2022-12-22T04:16:08ZengUniversidade de São PauloRevista de Saúde Pública1518-87872020-08-015410.11606/s1518-8787.2020054001661A methodology for apportioning federal SUS resources: the health needs indexÁquilas Mendeshttps://orcid.org/0000-0002-5632-4333Marcel Guedes Leitehttps://orcid.org/0000-0001-9305-9703Leonardo Carnuthttps://orcid.org/0000-0001-6415-6977ABSTRACT OBJECTIVE To present a methodology for apportioning Union resources to the federative units (FU – 26 states and one federal district) within the Brazilian Unified Health System (SUS) based on health needs measured by demographic, socioeconomic, epidemiological and geographical dimensions. METHODS The apportionment methodology proposal prioritizes the health needs axis, based on Law 141/2012. We adopted a proxy of needs that measures relative inequalities between, socioeconomic, geographic demographic and epidemiological conditions of the populations of the Brazilian Federative Units (FU) for 2015. We first used an adjustment so that the populations of the 27 FU are corrected by their relative needs regarding age and gender. To calculate the health needs axis, the multivariate techniques factorial analysis and principal components were used, and, based on such correction, we applied the health needs index. Subsequently, this index was applied to simulate the resources that should be transferred by the Ministry of Health to states in 2015. RESULTS As we made the methodological choice of transferring a single per capita amount to all states, so the proposal required population correction. Thus, in the analysis of health needs, the FUs that had their population corrected by a factor higher than the national average because of their greater relative need, were the states of: Maranhão, Piauí, Alagoas, Paraíba, Ceará, Pará, Bahia, Acre, Pernambuco, Rio Grande do Norte, Sergipe, Amazonas, Tocantins and Roraima. For the simulation aggregating all the financing blocks, without reducing the resources already distributed to the remaining states in 2015, indicated the additional need of R$ 4.6 billion. CONCLUSIONS The proposal addresses the absence of studies presenting quantitative simulations of federal resources distribution within the scope of SUS to the FUs, based on the apportionment criteria defined by Law 141/2012, in order to contribute to the reduction health inequalities and mitigate the effects of the economic crisis.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100255&tlng=enHealth Care Rationingmethods. Health Services Needs and Demandclassification. Unified Health Systemeconomy |
| spellingShingle | Áquilas Mendes Marcel Guedes Leite Leonardo Carnut A methodology for apportioning federal SUS resources: the health needs index Revista de Saúde Pública Health Care Rationing methods. Health Services Needs and Demand classification. Unified Health System economy |
| title | A methodology for apportioning federal SUS resources: the health needs index |
| title_full | A methodology for apportioning federal SUS resources: the health needs index |
| title_fullStr | A methodology for apportioning federal SUS resources: the health needs index |
| title_full_unstemmed | A methodology for apportioning federal SUS resources: the health needs index |
| title_short | A methodology for apportioning federal SUS resources: the health needs index |
| title_sort | methodology for apportioning federal sus resources the health needs index |
| topic | Health Care Rationing methods. Health Services Needs and Demand classification. Unified Health System economy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100255&tlng=en |
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