0216/2023 - Repasses financeiros para o enfrentamento da COVID-19 na perspectiva de gestores municipais do estado de São Paulo Financial transfers to coping with COVID-19the perspective of municipal managers in São Paulo State
O objetivo do estudo foi identificar a percepção dos gestores municipais sobre os recursos extraordinários e seus usos para o enfrentamento da COVID-19. Trata-se de estudo de casos múltiplos, de método mistos incorporados. Foram realizadas entrevistas semiestruturadas com seis municípios-caso do estado de São Paulo. Foram analisados dados secundários extraídos de sistemas de informação para o período 2020 a 2022. As diferentes realidades municipais em termos populacionais, de gastos em saúde e de acesso aos recursos federais permitiram observar diferentes estratégias de gestão financeira e alocação dos recursos. Além dos recursos extraordinários, foi possível identificar no período analisado a presença relevante dos repasses por Emendas Parlamentares. No contexto de desfinanciamento do SUS, os recursos extraordinários e os repasses por Emendas Parlamentares significaram, em muitos casos, a possibilidade dos gestores organizarem o sistema de saúde municipal segundo seu entendimento das necessidades de saúde e as respostas possíveis a essas necessidades. Evidenciou-se que os recursos para o enfrentamento à COVID-19 foram alocados principalmente na média e alta complexidade e na contratação de empresas privadas.
Palavras-chave:
Sistema Único de Saúde; COVID-19; Sistema Municipal de Saúde; Financiamento da Saúde; Gestão em Saúde.
Abstract:
The study aimed to identify municipal managers\' perception of extraordinary resources and their uses to cope with COVID-19. It is a multiple case study, quantitative and qualitative. We conducted semi-structured interviews with six municipalities in the state of São Paulo. Secondary data extractedinformation systems2020 to 2022 were analyzed. The different municipal realities in terms of population, health expenditures, and access to federal resources allowed observing different financial management strategies and resource allocation. In addition to the extraordinary resources, it was possible to identify, in the analyzed period, the relevant presence of budget transfers by Parliamentary Amendments. In the context of SUS underfunding, extraordinary resources, and budget transfers through Parliamentary Amendments meant, in many cases, the possibility for managers to organize the municipal health system according to their understanding of health needs and possible responses to these needs. The resources to cope with COVID-19 were mainly allocated to medium and high-complexity services and hiring private companies.
Keywords:
Unified Health System; COVID-19; Local Health Systems; Healthcare Financing; Health Management.
Financial transfers to coping with COVID-19the perspective of municipal managers in São Paulo State
Resumo (abstract):
The study aimed to identify municipal managers\' perception of extraordinary resources and their uses to cope with COVID-19. It is a multiple case study, quantitative and qualitative. We conducted semi-structured interviews with six municipalities in the state of São Paulo. Secondary data extractedinformation systems2020 to 2022 were analyzed. The different municipal realities in terms of population, health expenditures, and access to federal resources allowed observing different financial management strategies and resource allocation. In addition to the extraordinary resources, it was possible to identify, in the analyzed period, the relevant presence of budget transfers by Parliamentary Amendments. In the context of SUS underfunding, extraordinary resources, and budget transfers through Parliamentary Amendments meant, in many cases, the possibility for managers to organize the municipal health system according to their understanding of health needs and possible responses to these needs. The resources to cope with COVID-19 were mainly allocated to medium and high-complexity services and hiring private companies.
Palavras-chave (keywords):
Unified Health System; COVID-19; Local Health Systems; Healthcare Financing; Health Management.
Duarte, L.S, Viana, M.M.O, Garcia, M.T, Costa Rosa, T.E, Malinverni, C., Neves, M.V.F, Dantas, L.A.A. Repasses financeiros para o enfrentamento da COVID-19 na perspectiva de gestores municipais do estado de São Paulo. Cien Saude Colet [periódico na internet] (2023/ago). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/repasses-financeiros-para-o-enfrentamento-da-covid19-na-perspectiva-de-gestores-municipais-do-estado-de-sao-paulo/18842?id=18842
