Nunes Marinho Luiza, Campbell Stephen M, da S T Amaral Isabela Barboza, Reis E Silva Rebeca, Godman Brian, Meyer Johanna C, Godói Isabella Piassi D
Institute of Pharmaceutical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
School of Health Sciences, University of Manchester, Manchester, United Kingdom.
Front Public Health. 2025 Jun 9;13:1568351. doi: 10.3389/fpubh.2025.1568351. eCollection 2025.
The Unified Health System (SUS) in Brazil provides free, universal health services to all inhabitants of the country. This study aims to describe the allocation of public health resources in Brazil, both overall and across regions, based on National Health Fund (FNS) data from 2019 to 2022. The goal is to provide an understanding of the profile and distribution of resources sourced exclusively from the federal government during this period.
A quantitative, descriptive study using data extracted from the FNS portal covering the period 2019-2022, along with publications and open data linked to Brazil's Ministry of Health, was undertaken. Data collection included the resources allocated to health within each of the financing blocks (operational and investment), according to FNS as well as the Transparency Portal of the Office of the Comptroller General for more information about the COVID-19 pandemic.
A total of USD 75.310 billion (406.283 billion BRL) was allocated to health services between 2019 and 2022, with 64.6% allocated to Specialized, Medium, and High Complexity Care and 30.2% to Primary Health Care (USD 21.096 billion). A lower percentage was dedicated to investment actions within the SUS, and there was heterogeneous distribution of resources across the country's regions, with the Southeast receiving the most resources (38.5%), while the Central-West region received only 7.7%. In addition, more than USD 111 billion (600 billion BRL) was allocated by the federal government to the COVID-19 pandemic response, not exclusively for health-related purposes.
The distribution profile of resources transferred from the FNS reflected population sizes but it is less clear whether resources were allocated based on need. Overall, there was a scarcity of resources allocated to areas such as investment. However, the COVID-19 pandemic represented a considerable impact on government funds. Health and social needs must be assessed and considered going forward to improve the allocation of resources within a unified health system.
巴西的统一卫生系统（SUS）为该国所有居民提供免费的全民健康服务。本研究旨在根据2019年至2022年国家卫生基金（FNS）的数据，描述巴西公共卫生资源的总体分配情况以及各地区的分配情况。目的是了解在此期间完全来自联邦政府的资源概况和分布情况。
采用定量描述性研究，使用从FNS门户网站提取的2019 - 2022年期间的数据，以及与巴西卫生部相关的出版物和开放数据。数据收集包括根据FNS以及总审计长办公室透明度门户网站分配到每个融资板块（运营和投资）内卫生领域的资源，以获取更多关于新冠疫情的信息。
2019年至2022年期间，共向卫生服务领域拨款753.10亿美元（4062.83亿巴西雷亚尔），其中64.6%分配给专科、中级和高复杂度护理，30.2%分配给初级卫生保健（210.96亿美元）。SUS内用于投资行动的比例较低，且资源在全国各地区分布不均，东南部获得的资源最多（38.5%），而中西部地区仅获得7.7%。此外，联邦政府为应对新冠疫情拨款超过1110亿美元（6000亿巴西雷亚尔），并非专门用于与卫生相关的目的。
FNS转移的资源分配情况反映了人口规模，但资源是否按需分配尚不清楚。总体而言，投资等领域的资源稀缺。然而，新冠疫情对政府资金产生了重大影响。未来必须评估和考虑卫生与社会需求，以改善统一卫生系统内的资源分配。
