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[公共预算、地区与医疗保健资金:石油收入与各市镇之间的不平等]

[Public budget, region and funding in health care: oil revenues and inequalities between municipalities].

作者信息

Barros Delba Machado, de Lima Luciana Dias

机构信息

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil,

Departamento de Administração e Planejamento em Saúde, ENSP, Fundação Oswaldo Cruz, Brasil.

出版信息

Cien Saude Colet. 2015 Oct;20(10):2973-84. doi: 10.1590/1413-812320152010.00722015.

Abstract

The effects of the allocation of revenues from oil production on socioeconomic development and the funding of public policies have been questioned in the literature. The main objective of this study was to analyze the importance of financial compensation - in the form of royalties and special participation - for public financing of local health services in the Norte Fluminense region of Rio de Janeiro State, namely the state bordering on the offshore area that accounts for more than 70% of the oil produced in Brazil. The methodology involved secondary data analysis of municipal health revenues and expenditures in the 2000s. The results suggest that the variation in oil-derived budget funds were correlated to the significant difference in total health spending in the region's municipalities. However, the execution and distribution of health spending by specialty did not occur proportionally to the variation in the availability of revenues. The heavy dependence on oil revenues suggests greater municipal autonomy in health spending when compared to other municipalities in Brazil. The conclusion drawn is that other criteria for the distribution and use of funds are needed in order to equalize spending and streamline governmental actions in the regional sphere.

摘要

石油生产收入分配对社会经济发展和公共政策资金投入的影响在文献中受到了质疑。本研究的主要目的是分析以特许权使用费和特殊参股形式存在的财政补偿对里约热内卢州北弗卢米嫩塞地区地方卫生服务公共融资的重要性,该地区是与近海区域接壤的州,巴西70%以上的石油产自该近海区域。研究方法包括对21世纪各市政府卫生收入和支出的二手数据分析。结果表明,石油衍生预算资金的变化与该地区各市政府卫生总支出的显著差异相关。然而,按专业划分的卫生支出的执行和分配与收入可得性的变化不成比例。与巴西其他城市相比,对石油收入的严重依赖表明各市政府在卫生支出方面拥有更大的自主权。得出的结论是,需要其他资金分配和使用标准,以平衡支出并简化区域层面的政府行动。

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