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[按筹资系统分析卫生服务利用情况:巴西,1998 - 2008年]

[An analysis of use of the health services by financing system: Brazil 1998-2008].

作者信息

Porto Silvia Marta, Ugá Maria Alicia Dominguez, Moreira Rodrigo da Silva

机构信息

Escola Nacional de Saúde Pública, Fiocruz, Rio de Janeiro, RJ, 22241-210, Brazil.

出版信息

Cien Saude Colet. 2011 Sep;16(9):3795-806. doi: 10.1590/s1413-81232011001000015.

Abstract

This article analyzes the use of health services from the perspective of financing based on PNAD/IBGE micro-data related to 1998, 2003 and 2008. Among the main results, the following can be highlighted: 1) The Unified Health System (SUS) continues to be the major financing agent of most consultations and hospitalizations in Brazil; its participation increased significantly between 1998 and 2003 and remained almost stable between 2003 and 2008; 2) SUS participation in financing the use of the health services has been predominant in all Brazilian regions, especially in the North and North-East, which feature the most precarious socio-economic and health conditions; 3) SUS is the major financing agent of the two extreme levels of complexity of health care: primary care and high complexity services. 4) In spite of a significant rise in utilization rates of SUS services for consultations and hospitalizations, great inequities can still be observed between the population that exclusively uses SUS and that which has private health insurance; 5) There has been an increase in the use of SUS health services by part of the population with private health insurance plans.

摘要

本文基于巴西地理与统计研究所(IBGE)1998年、2003年和2008年的全国住户抽样调查(PNAD)微观数据,从筹资角度分析了卫生服务的利用情况。在主要结果中,以下几点值得强调:1)统一卫生系统(SUS)仍然是巴西大多数门诊和住院治疗的主要筹资机构;其参与度在1998年至2003年间显著提高,在2003年至2008年间几乎保持稳定;2)SUS在为卫生服务利用筹资方面的参与在巴西所有地区都占主导地位,特别是在社会经济和健康状况最不稳定的北部和东北部地区;3)SUS是初级保健和高复杂性服务这两个极端复杂程度的卫生保健的主要筹资机构。4)尽管SUS门诊和住院服务的利用率显著提高,但在完全使用SUS服务的人群和拥有私人健康保险的人群之间,仍然可以观察到巨大的不平等;5)拥有私人健康保险计划的部分人群对SUS卫生服务的使用有所增加。

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