[Effects of parliamentary amendments on municipal financing of primary health care in the Brazilian Unified National Health System].

Autor: Ulinski KGB; Universidade Estadual de Londrina, Londrina, Brasil., Carvalho BG; Universidade Estadual de Londrina, Londrina, Brasil., Vieira FS; Instituto de Pesquisa Econômica Aplicada, Brasília, Brasil., Rodrigues R; Universidade Estadual de Londrina, Londrina, Brasil., Lima LD; Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Jazyk: portugalština
Zdroj: Cadernos de saude publica [Cad Saude Publica] 2024 Apr 22; Vol. 40 (3), pp. e00007323. Date of Electronic Publication: 2024 Apr 22 (Print Publication: 2024).
DOI: 10.1590/0102-311XPT007323
Abstrakt: This study aims to analyze the effects of the expansion of the federal transfer of parliamentary amendments for municipal financing of primary health care (PHC) in the Brazilian Unified National Health System (SUS), from 2015 to 2020. A longitudinal study was conducted using secondary data on transfers of parliamentary amendments from the Brazilian Ministry of Health and expenditure of municipalities' own resources on public health actions and services and PHC. The effect of the transfer of parliamentary amendments on municipal financing was verified in a stratified way by population size of the municipalities, using generalized estimating equation models. The transfer of parliamentary amendments for PHC showed a large discrepancy in per capita values among municipalities of different population sizes. No correlation with municipal spending on public health actions and services was observed in municipalities with more than 10,000 inhabitants, and the association with spending on PHC (p < 0.050) was inverse in all municipalities. Therefore, the increase in the transfer of parliamentary amendments by the Brazilian Ministry of Health favored a reduction in the allocation of municipal revenues to PHC, which may have been directed to other spending purposes in the SUS. These changes seem to represent priorities established for municipal budget expenditure, which have repercussions on local conditions for guaranteeing stable funding for PHC in Brazil.
Databáze: MEDLINE