Ribeiro José Mendes, Moreira Marcelo Rasga, Ouverney Assis Mafort, Silva Cosme Marcelo Furtado Passos da
Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2017 Apr;22(4):1031-1044. doi: 10.1590/1413-81232017224.03732017.
This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.
本文依据1988年宪法所确立的分权进程引发的单一卫生系统（SUS）合作联邦制危机中的服务提供能力，对巴西各卫生区域进行了分析。按区域选取了服务提供能力追踪指标，统计分析表明，医院护理方面的区域能力更强，但在医生配备、高复杂性设备以及私人保险覆盖范围方面存在较大差距。总之，我们认为需要进一步寻求解决方案，以通过加强中央协调来增强政府减少区域不平等的能力。
