Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Faculdade de Ciências da Saúde, Centro Universitário Presidente Antônio Carlos UNIPAC, Juiz de Fora 36025-030, Brazil.
Int J Environ Res Public Health. 2023 Feb 9;20(4):3006. doi: 10.3390/ijerph20043006.
The following paper presents as a research problem the ethnic-regional differences in the allocation of high complexity spending in Brazil in an analysis from 2010 to 2019. This is a descriptive research in which a generalized linear model (GLM) was developed to analyze these hospital expenditures with high complexity procedures. The total spending on high complexity procedures in Brazil has increased over the past decade. The study shows that the lowest average expenditures are found in the North and Northeast regions. When comparing the spending between different ethnicities, it was observed that the only decrease between the years 2010 and 2019 was in the amount spent on procedures in indigenous people. The spending on male patients was significantly higher compared to female patients. The highest expenditures, on the other hand, are concentrated in the regions of state capitals favoring the strengthening of hub municipalities. Geographic inequalities in access still persist, even with most states already offering almost all procedures. The Brazilian territory is very heterogeneous and needs to organize its health system by regions, therefore integrated public policies and economic and social development are urgently needed.
本文提出了一个研究问题，即在巴西，2010 年至 2019 年期间，高复杂度支出在种族和地区之间的分配存在差异。这是一项描述性研究，采用广义线性模型（GLM）对高复杂度手术的这些医院支出进行了分析。巴西高复杂度手术的总支出在过去十年中有所增加。研究表明，北部和东北部地区的平均支出最低。在比较不同种族之间的支出时，发现在 2010 年至 2019 年期间，只有土著居民的手术支出有所减少。与女性患者相比，男性患者的支出明显更高。另一方面，支出最高的地区集中在州首府，有利于加强枢纽城市。尽管大多数州已经提供了几乎所有的程序，但在获得服务方面仍存在地理不平等。巴西领土非常多样化，需要按地区组织其卫生系统，因此迫切需要制定综合公共政策以及促进经济和社会发展。
