Araújo Carmem Emmanuely Leitão, Gonçalves Guilherme Quaresma, Machado José Angelo
Departamento de Ciência Política, Faculdade de Filosofia e Ciências Humanas, Universidade Federal de Minas Gerais (UFMG). Av. Pres. Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
Centro de Desenvolvimento e Planejamento Regional, Faculdade de Ciências Econômicas, UFMG. Belo Horizonte MG Brasil.
Cien Saude Colet. 2017 Mar;22(3):953-963. doi: 10.1590/1413-81232017223.15542016.
In a context that combines decentralization and underfunding of public health policy, Brazilian municipalities expressively extend their spending in this sector, allocating a proportion of their own revenues (direct taxation added to the mandatory intergovernmental transfers from the Union and the states) at levels above the ones that are constitutionally determined. However, there have been incipient studies investigating the expenditure composition on health in these federative units, in order to describe its main characteristics and explanations. In order to contribute to eliminating this gap, this article explores some associations between attributes of the municipalities (population size, region of the country, the proportion of older adults, child mortality, hiring private services and SUS transfer) and health expenditure implemented with the municipalities' own recipes. The study used descriptive statistics and multiple linear regressions in order to investigate such associations with data for 2010. The results point to tax inequities in the sector when comparing municipalities of different population groups and socioeconomic conditions, including the perception of important differences in terms of per capita spending on the analyzed expenditure items.
在公共卫生政策权力下放且资金不足的背景下，巴西各市大幅增加了该部门的支出，将自身收入（直接税收加上联邦和州政府强制性的政府间转移支付）的一定比例用于卫生领域，且该比例高于宪法规定的水平。然而，目前仅有初步研究对这些联邦单位的卫生支出构成进行调查，以描述其主要特征并作出解释。为填补这一空白，本文探讨了各市的属性（人口规模、所在地区、老年人比例、儿童死亡率、购买私人服务情况以及统一卫生系统转移支付）与用各市自有资金实施的卫生支出之间的一些关联。该研究运用描述性统计和多元线性回归，依据2010年的数据来调查此类关联。结果表明，在比较不同人口群体和社会经济状况的各市时，该领域存在税收不公平现象，包括在所分析的支出项目上人均支出存在显著差异。
