1700/2012 - Regulation of radiotherapy and chemotherapy services by health plan organizations in Brazil
Regulação dos serviços de radioterapia e quimioterapia pelas operadoras de planos de saúde no Brasil
Publicado
Author:
• Sheyla Maria Lemos Lima - Lima, S.M.L. - Rio e Janeiro, RJ - ESCOLA NACIONAL DE SAÚDE PÚBLiCA / FIOCRUZ - <slemos@ensp.fiocruz.br> +ORCID: https://orcid.org/0000-0003-1450-0498
Co-author(s):
• Margareth Crisóstomo Portela - Portela M.C - Rio de Janeiro, RJ - Departamento de Administração e Planejamento em Saúde Escola Nacional de Saúde Pública/ Fundação Oswaldo Cruz/Ministério da Saúde - <mportela@ensp.fiocruz.br>ORCID: https://orcid.org/0000-0002-9858-9276
• Maria Alicia Dominguez Ugá - UGÁ, M A D - Departamento de Administração e Planejamento em Saúde Escola Nacional de Saúde Pública/ Fundação Oswaldo Cruz/Ministério da Saúde - <domingue@ensp.fiocruz.br>
• Maurício Teixeira Leite de Vasconcellos - Vasconcellos, M.T.L - Escola Nacional de Ciências Estatísticas, Fundação Instituto Brasileiro de Geografia e Estatística - <mautlv@gmail.com>
ORCID: https://orcid.org/0000-0003-1658-2589
Thematic Area:
Planejamento e Gestão em SaúdeAbstract:
This paper characterizes regulatory procedures applied by private health plans on their outpatient radiotherapy and chemotherapy services, especially contracts, and provides the health care providers’ perception on regulation.The study relied on primary data, accounting for 638 hospitals and outpatient health care units with the mentioned services. A stratified sample was selected, resulting in the inclusion of 54 units representative of the population, excluding hospitals with only radiotherapy.
Private chemotherapy services are largely funded by private insurance (75.0%), while radiotherapy services are majorly covered by the public health system (49.0%). Contracts are not applied by third part payers, in their potential, as regulatory and health care coordination instruments.
The mechanisms of regulation applied by third part payers are centered on services use control and administrative aspects. It is recognized the need of adjustments for a health care quality focus, and contracts may contribute in this sense.
