0236/2019 - A crise financeira e a saúde: O caso do município do Rio de Janeiro. Financial crisis and healthcare: The case of the municipality of Rio de Janeiro.
Este estudo explorou os efeitos da crise financeira nas receitas e despesas, na produção de serviços e indicadores de saúde e de desempenho no município do Rio de Janeiro no período de 2013 a 2018. Analisou-se receitas, despesas, parâmetros de provisão de serviços e indicadores de desempenho e de saúde, a partir de dados de acesso livre e restrito. Utilizou-se a análise institucional de Giddens. As receitas e despesas sofreram redução, sendo maiores nos investimentos e receitas não vinculadas. A provisão de serviços encolheu, com queda da cobertura na Atenção Primária, produção ambulatorial, internações totais, número de leitos, médicos e agentes comunitários de saúde, cirurgias realizadas e taxa de ocupação de hospitais. Os tempos de espera para ambulâncias, exames e consultas ambulatoriais, bem como o número de solicitações pendentes na regulação aumentaram. Indicadores de saúde e desempenho persistiram, em sua maioria, dentro dos parâmetros anteriores, corroborando a potência assistencial da Atenção Primária, apesar do impacto financeiro e estrutural da austeridade. A conjuntura atual ameaça o direito à saúde e as respostas governamentais, como a desvinculação de receitas, sinalizam uma ampliação desse risco.
Palavras-chave:
Política Pública; Atenção Primária à Saúde; Assistência à Saúde; Financiamento da Assistência à Saúde; Indicadores de Serviços
Abstract:
Introduction: This study aimed to depict the effects of the financial crisis that struck Brazil and specially the city of Rio de Janeiro through an analysis of healthcare expenditure, access and provision of healthcare and health status and performance indicators. Methods: Documental analysis and statistical analysis of primary and secondary data were performed. The interpretation of the results resorted to the conceptual framework of Giddens’ Structuration Theory. Results: Health budgets shrunk and healthcare expenditure was reduced, especially for investments and discretionary funds. Health services provision suffered, resulting in decreased primary care coverage. A reduction on the number of consultations, hospital admissions, physicians, lay workers, surgeries performed and bed occupancy was observed. Waiting times for ambulances, exams and consultations increased. Health status and performance indicators remained largely unchanged. Conclusions: This scenario reveals the positive and effective impact of a primary care driven health system, despite financial and structural contingencies imposed by the Austerity agenda. Nonetheless, if sustained, this agenda may represent a serious threat the right to health.
Keywords:
Public Policy; Primary Health Care; Delivery of Healthcare; Healthcare Financing; Indicators of Health Services
Financial crisis and healthcare: The case of the municipality of Rio de Janeiro.
Resumo (abstract):
Introduction: This study aimed to depict the effects of the financial crisis that struck Brazil and specially the city of Rio de Janeiro through an analysis of healthcare expenditure, access and provision of healthcare and health status and performance indicators. Methods: Documental analysis and statistical analysis of primary and secondary data were performed. The interpretation of the results resorted to the conceptual framework of Giddens’ Structuration Theory. Results: Health budgets shrunk and healthcare expenditure was reduced, especially for investments and discretionary funds. Health services provision suffered, resulting in decreased primary care coverage. A reduction on the number of consultations, hospital admissions, physicians, lay workers, surgeries performed and bed occupancy was observed. Waiting times for ambulances, exams and consultations increased. Health status and performance indicators remained largely unchanged. Conclusions: This scenario reveals the positive and effective impact of a primary care driven health system, despite financial and structural contingencies imposed by the Austerity agenda. Nonetheless, if sustained, this agenda may represent a serious threat the right to health.
Palavras-chave (keywords):
Public Policy; Primary Health Care; Delivery of Healthcare; Healthcare Financing; Indicators of Health Services
O´Dwyer, G., Graever, L, Britto, F.A, Menezes, T, Konder, M.T. A crise financeira e a saúde: O caso do município do Rio de Janeiro.. Cien Saude Colet [periódico na internet] (2019/ago). [Citado em 22/01/2025].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/a-crise-financeira-e-a-saude-o-caso-do-municipio-do-rio-de-janeiro/17310?id=17310&id=17310
