0079/2023 - Maintenance of medium and high complexity health services in a context of large patient transition: a time series ecological study of the State of Rio de Janeiro
Manutenção dos serviços de média e alta complexidade em contexto de alta transição de usuários: um estudo ecológico de séries temporais no Estado do Rio de Janeiro
Publicado
Author:
• Paula de Castro Nunes - Nunes,P.C - <paula.nunes@fiocruz.br>ORCID: https://orcid.org/0000-0002-9117-9805
Co-author(s):
• Hugo Bellas - Bellas.H. - <hugo.bellas@fiocruz.br>ORCID: https://orcid.org/0000-0002-1852-9047
• Érica Tex Paulino - Paulino, E.T - <ericatex@gmail.com>
ORCID: https://orcid.org/0000-0003-3808-7415
• André Ramos - Ramos, A. - <andrepaesramos@gmail.com>
ORCID: https://orcid.org/0000-0002-3262-7321
• Alessandro Jatobá - Jatobá, A. - <alessandro.jatoba@fiocruz.br>
ORCID: https://orcid.org/0000-0002-7059-6546
Abstract:
The study addresses the historical disparities in the distribution of medium and high complexity health network and the limits to budget adjustments between the municipality of Rio de Janeiro and its neighboring municipalities of the Metropolitan region 1.An ecological study was conducted with data referring to the municipality of Rio de Janeiro, chosen because it has a large assistance network, while located on the borders of vulnerable and underprivileged areas, characterizing a locus representative of the situations faced throughout the country.
A decrease in the gross values of the programmed quotas in all municipalities of Rio de Janeiro2016 onwards was observed. The temporal trend of the programmed quotas remained stable for all municipalities in the Metropolitan Region 1, even with significant increases in the executed quotas for neighboring municipalities.
The resulting overload in local expenditure prevents the increase of capacity to anticipate fluctuations in demand, both known and unexpected, compromising the responsiveness of the health system regarding its regular functioning, as well as the ability to adjust to cope with extraordinary events, essential characteristics of resilience.
