Albuquerque Mariana Vercesi de, Viana Ana Luiza d'Ávila, Lima Luciana Dias de, Ferreira Maria Paula, Fusaro Edgard Rodrigues, Iozzi Fabíola Lana
Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480/Prédio da Ensp/709, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Departamento de Medicina Preventiva Faculdade de Medicina Universidade de São Paulo. São Paulo SP Brasil.
Cien Saude Colet. 2017 Apr;22(4):1055-1064. doi: 10.1590/1413-81232017224.26862016.
Advances in reducing poverty and inequalities in the 2000s had a paradoxical effect in Brazil. This article examines how socioeconomic transformations, and the complexity of health services, are expressed in the regions established for planning purposes and the inter-governmental management of the Brazilian Unified Health System. An effort was made to identify and explain differences in the compositions of the 438 existing health regions and their spatial distribution by comparing situations observed in 2016 with those in 2000. Factor analysis and grouping techniques were used to construct a typology in the two years of the series, which was based on a diverse set of secondary data sources. It was found that there was an evolution in terms of income levels and service provision within the health regions, with a significant improvement in the socioeconomic conditions of the population. These results suggest that there was a positive impact from the combination of strategies related to social, economic and regional policies for the promotion of development, which generated more widespread well-being within the affected areas. However, limitations remain regarding the policies implemented for the universalization of the health system.
21世纪巴西在减贫和减少不平等方面取得的进展产生了自相矛盾的效果。本文探讨社会经济转型以及卫生服务的复杂性如何在为规划目的而设立的区域以及巴西统一卫生系统的政府间管理中体现出来。通过比较2016年和2000年观察到的情况，努力识别并解释438个现有卫生区域的构成差异及其空间分布。在该系列的两年中，使用因子分析和分组技术构建了一种类型学，其基于各种二手数据源。研究发现，卫生区域内的收入水平和服务提供情况有所演变，人口的社会经济状况有显著改善。这些结果表明，与促进发展的社会、经济和区域政策相关的战略组合产生了积极影响，在受影响地区带来了更广泛的福祉。然而，在卫生系统普及所实施的政策方面仍存在局限性。
