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[巴西卫生部为基本医疗保健提供激励措施的政策:对市行政管理人员自主权和整体性原则的威胁?]

[Brazilian Ministry of Health policy providing incentives for basic health care: a threat to the autonomy of Municipal administrators and the principle of integrality?].

作者信息

Marques Rosa Maria, Mendes Aquilas

机构信息

Departamento de Economia, Faculdade de Economia e Administração, Pontifícia Universidade Católica de São Paulo, São Paulo, SP, 05014-901, Brasil.

出版信息

Cad Saude Publica. 2002;18 Suppl:163-71. Epub 2003 Jan 21.

Abstract

Thirteen years after the Unified National Health System was implemented in Brazil, the Federal government increased the use of norms and regulations aimed at rationalizing resources and prioritizing basic care within the system. In other words, although actions and services are the responsibility of Municipal governments, the Federal government used financing to reinforce its role in determining the policy to be adopted. The first part of this article analyzes trends in health care expenditures and financing in the country and priorities and strategies for financing. The second part relates the 1996 Basic Operational Norm to the Federal government policy of transferring resources to the Municipalities, discussing the importance of the Family Health Program as part of the financing logic and the role of the Health Care Operational Norm in reinforcing rationalization and emphasizing basic care.

摘要

在巴西实施统一国家卫生系统13年后,联邦政府加大了对规范和条例的运用,旨在使系统内的资源合理化并优先保障基本医疗服务。换句话说,尽管行动和服务由市政府负责,但联邦政府通过资金支持来强化其在确定应采取政策方面的作用。本文第一部分分析了该国医疗保健支出和融资的趋势以及融资的优先事项和战略。第二部分将1996年基本操作规范与联邦政府向各市转移资源的政策联系起来,讨论了家庭健康计划作为融资逻辑一部分的重要性以及医疗保健操作规范在加强合理化和强调基本医疗服务方面的作用。

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