0283/2021 - Saldos dos repasses federais no SUS: o que temos e o que esperar do incremento para a COVID-19 Balances of federal transfers in SUS: what we have and what to expectthe COVID-19 increment
Analisamos os saldos provenientes dos repasses do Ministério as Saúde (MS) aos entes subnacionais, destinados ao financiamento do Sistema Único de Saúde (SUS), inclusive para COVID-19. Verificamos a representatividade destes frente aos repasses do MS destinados às ações e serviços públicos de saúde, entre 2019 e 2020. Analisamos as portarias do MS que deram origem aos repasses COVID-19, classificando-as em: quantidade; objeto; critério rateio; quantidade parcelas; execução vinculadas a estratégias do MS; valor. Mais de 70.000 contas-correntes foram contabilizadas, alguns entes subnacionais tinham mais de 100. Em 2019, saldos atingiram R$16,29 bilhões (aumento anual de 10,2%), representando 19,9% do total repassado. Em 2020, R$23,83 bilhões (aumento de 46,3%), representando 21,1% do repassado, com tendência de crescimento. Mais de 616 portarias, com 28 diferentes objetivos, repassaram R$32,30 bilhões à COVID-19. O recurso, antes de livre utilização, teve R$11,88 bilhões (36,8%) vinculados as estratégias do MS: R$1,36 bilhão (99,9%) Bloco Estruturação e R$10,52 bilhões (34,0%) Bloco Manutenção. Várias podem ser as causas que dão origem ao acúmulo de saldos, todavia qualidade, quantidade e complexidade do arcabouço normativo do SUS contribuem fortemente para uma execução dos recursos pouco célere, efetiva, eficiente e eficaz.
Palavras-chave:
Saúde pública; Economia da Saúde; Orçamentos
Abstract:
We analyzed the balancesthe transfersthe Ministry of Health (MoH) to subnational entities, to finance the Unified Health System (SUS), including for COVID-19. We verified the representativeness of these vis-à-vis the transfersthe MoH to public health actions and services (2019/2020). We analyzed the MoH ordinances that gave rise to the COVID-19 transfers, classifying them as: quantity; object; apportionment criterion; amount of installments transferred; whether or not execution is linked to MoH strategies; value. In 2019, balances reached R$16.29 billion (annual increase of 10.2%), representing 19.9% of the total transferred. In 2020, they reached R$23.83 billion (an increase of 46.3%), representing 21.1% of the transferred, with a monthly trend of continued growth. More than 616 ordinances, with 28 different objectives, transferred R$32.30 billion to COVID-19. The resource before unrestricted use had R$11.88 billion (36.8%) linked to the strategies of the MoH, in the Structuring Block, andR$1.36 billion (99.9%) were tied and Maintenance R$10.52 billion (34.0%).There are several causes that give rise to the accumulation of balances, however the quality, quantity and complexity of the SUS normative framework strongly contribute to a slow, effective, efficient and effective implementation of resources.
Balances of federal transfers in SUS: what we have and what to expectthe COVID-19 increment
Resumo (abstract):
We analyzed the balancesthe transfersthe Ministry of Health (MoH) to subnational entities, to finance the Unified Health System (SUS), including for COVID-19. We verified the representativeness of these vis-à-vis the transfersthe MoH to public health actions and services (2019/2020). We analyzed the MoH ordinances that gave rise to the COVID-19 transfers, classifying them as: quantity; object; apportionment criterion; amount of installments transferred; whether or not execution is linked to MoH strategies; value. In 2019, balances reached R$16.29 billion (annual increase of 10.2%), representing 19.9% of the total transferred. In 2020, they reached R$23.83 billion (an increase of 46.3%), representing 21.1% of the transferred, with a monthly trend of continued growth. More than 616 ordinances, with 28 different objectives, transferred R$32.30 billion to COVID-19. The resource before unrestricted use had R$11.88 billion (36.8%) linked to the strategies of the MoH, in the Structuring Block, andR$1.36 billion (99.9%) were tied and Maintenance R$10.52 billion (34.0%).There are several causes that give rise to the accumulation of balances, however the quality, quantity and complexity of the SUS normative framework strongly contribute to a slow, effective, efficient and effective implementation of resources.
Faleiros, D. R., Pereira, B. L. S.. Saldos dos repasses federais no SUS: o que temos e o que esperar do incremento para a COVID-19. Cien Saude Colet [periódico na internet] (2021/ago). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/saldos-dos-repasses-federais-no-sus-o-que-temos-e-o-que-esperar-do-incremento-para-a-covid19/18182?id=18182
