Leite Valéria Rodrigues, Lima Kenio Costa, de Vasconcelos Cipriano Maia
Departamento de Odontologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN.
Cien Saude Colet. 2012 Jul;17(7):1849-56. doi: 10.1590/s1413-81232012000700024.
This article investigates the issue of funding and the decentralization process in order to examine the composition, application and management of resources in the healthcare area. The sample surveyed involved 14 municipalities in the state of Rio Grande do Norte, Brazil. The research involved data gathering of financial transfers, the municipality's own resources and primary healthcare expenses. Management analysis included a survey of local managers and counselors. It was seen that the Unified Health System is funded mainly by federal transfers and municipal revenues and to a far lesser extent by state resources. Funds have been applied predominantly in primary healthcare. The management process saw centralization of actions in the city governments. Municipal secretarial offices and councils comply partially with legislation, though they have problems with autonomy and social control. The results show that planning and management instruments are limited, due to the contradictions inherent to the institutional, political and cultural context of the region.
本文研究了资金问题和权力下放过程，以审视医疗保健领域资源的构成、应用和管理。所调查的样本涉及巴西北里奥格兰德州的14个市。该研究涉及财政转移支付、市自有资源和初级医疗保健费用的数据收集。管理分析包括对地方管理人员和顾问的调查。可以看出，统一卫生系统主要由联邦转移支付和市财政收入提供资金，而州资源提供的资金所占比例要小得多。资金主要应用于初级医疗保健。管理过程中，市政府的行动出现了集中化。市秘书处和议会部分遵守立法，但在自主权和社会控制方面存在问题。结果表明，由于该地区制度、政治和文化背景中固有的矛盾，规划和管理手段有限。
