Montekio Víctor Becerril, Medina Guadalupe, Aquino Rosana
Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Salud Publica Mex. 2011;53 Suppl 2:s120-31.
This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.
本文介绍了巴西的卫生系统,其中包括覆盖近75%人口的公共部门以及为其余人口提供卫生服务且规模不断扩大的私营部门。公共部门围绕统一卫生系统(SUS)组织架构,其资金来源于三级政府(联邦、州和市)征收的一般税收和社会缴款。SUS通过诊所、医院和其他机构的分散式网络以及与私营提供者签订的合同来提供医疗保健服务。SUS还负责公共部门的协调工作。私营部门包括一个名为补充健康保险计划的体系,该体系由雇主和/或家庭出资:团体医疗保险(公司和家庭)、医疗合作社、所谓的自我管理计划(公司)以及个人保险计划。私营部门还包括诊所、医院和实验室,它们主要为高收入人群提供自费服务。本文还描述了该系统的资源、卫生部及其他行为主体开展的管理活动,以及巴西最近实施的政策创新举措,包括家庭健康计划和更多健康计划。