| Autor: |
Nunes PC; Centro de Estudos Estratégicos Antônio Ivo de Carvalho, Fundação Oswaldo Cruz. Av. Brasil 4036/10º andar, Prédio da Expansão, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil. paula.nunes@fiocruz.br., Bellas H; Centro de Estudos Estratégicos Antônio Ivo de Carvalho, Fundação Oswaldo Cruz. Av. Brasil 4036/10º andar, Prédio da Expansão, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil. paula.nunes@fiocruz.br., Paulino ÉT; Programa de Pós-Graduação em Medicina Topical, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil., Ramos A; Secretaria Municipal de Saúde do Rio de Janeiro. Rio de Janeiro RJ Brasil., Jatobá A; Centro de Estudos Estratégicos Antônio Ivo de Carvalho, Fundação Oswaldo Cruz. Av. Brasil 4036/10º andar, Prédio da Expansão, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil. paula.nunes@fiocruz.br. |
| Jazyk: |
Portuguese; English |
| Zdroj: |
Ciencia & saude coletiva [Cien Saude Colet] 2024 Jan; Vol. 29 (1), pp. e16542022. Date of Electronic Publication: 2023 Apr 05. |
| DOI: |
10.1590/1413-81232024291.16542022 |
| Abstrakt: |
The study addresses the historical disparities in the distribution of the medium- and high-complexity health network and the limits to budget adjustments between the municipality of Rio de Janeiro and its neighboring municipalities of the Metropolitan region 1. An ecological study was conducted with data related to the municipality of Rio de Janeiro, chosen because it has a large assistance network, while located on the borders of vulnerable and underprivileged areas, characterizing a locus that is representative of the situations faced throughout the country. A decrease in the gross values of the programmed quotas in all municipalities of Rio de Janeiro was observed from 2016 onwards. The temporal trend of the programmed quotas remained stable for all municipalities in the Metropolitan Region 1, even with significant increases in the accomplished quotas for neighboring municipalities. The resulting overload in local expenditure prevents the increase of capacity to anticipate fluctuations in demand, both known and unexpected ones, compromising the responsiveness of the health system regarding its regular operation, as well as the ability to adjust to cope with extraordinary events, essential characteristics of resilience. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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