Instituto de Pesquisa Econômica Aplicada. Diretoria de Estudos e Políticas Sociais. Brasília, DF, Brasil.
Rev Saude Publica. 2020 Dec 14;54:127. doi: 10.11606/s1518-8787.2020054002414. eCollection 2020.
To examine the financing of the Unified Health System (SUS) from 2010 to 2019 and analyze the recent trends in the allocation of federal resources to large areas of operation of the system, as well as the possibility of achieving the Sustainable Development Goal (SDG) 3 of the 2030 Agenda.
Data from the budgetary and financial execution of the federation entities were obtained. Transfers from the Brazilian Ministry of Health (MH) to the municipal and state departments and their direct applications were identified according to large final areas of SUS and middle areas. Basic descriptive statistics, graphs and tables were used to analyze the execution of expenses by these areas.
Public spending per capita on health increased between 2010 and 2018. However, compared to 2014, it reduced 3% in 2018. There was a displacement of the allocation of federal resources to the detriment of transfers to the states (-21%). There are also losses of health surveillance in favor of primary care and pharmaceuticals. In the case of primary care, the increase in spending was tied to changes in policy and the expansion of resources allocated by parliamentary amendments. In the case of pharmaceuticals, the increase was due to the incorporation of new drugs, including vaccines, judicialization, increased spending on blood products and centralization, in the MH, of the purchase of items of high budgetary impact.
If there is no change in the current SUS financing framework, something unlikely under Constitutional Amendment No. 95, associated with the redefinition of health policy priorities, the risk of non-compliance with the SDG 3 of the Agenda 2030 is very high.
审视 2010 年至 2019 年期间统一卫生系统（SUS）的融资情况，并分析联邦资源向系统主要运营领域分配的近期趋势，以及实现 2030 年议程可持续发展目标 3 的可能性。
获取联邦实体预算和财务执行情况的数据。根据 SUS 的主要最终领域和中间领域，确定来自巴西卫生部（MH）向市和州部门的转移及其直接应用。采用基本描述性统计、图表和表格来分析这些领域的支出执行情况。
人均卫生支出从 2010 年至 2018 年有所增加。然而，与 2014 年相比，2018 年减少了 3%。联邦资源的分配向不利于各州的转移发生了转移（-21%）。此外，还存在着卫生监测向初级保健和药品倾斜的情况。在初级保健方面，支出的增加与政策变化和议会修正案分配的资源扩张有关。在药品方面，支出的增加是由于新药物（包括疫苗）的加入、司法化、血液制品支出的增加以及 MH 对高预算影响项目的采购的集中化。
如果当前 SUS 融资框架没有变化，考虑到第 95 号宪法修正案的重新定义了卫生政策优先事项，不太可能发生这种情况，那么 2030 年议程可持续发展目标 3 不达标风险非常高。
