• Paulo Roberto Fagundes da Silva - Fagundes, P. - Rio de Janeiro, Rio de Janeiro - Departamento de Ciências Sociais/ENSP/FIOCRUZ - <PAULOFAGUNDES@ENSP.FIOCRUZ.BR>
O artigo analisa o regime de regulação da assistência à saúde mental implantado pela Agência Nacional de Saúde Suplementar. Descreve as condições observadas entre a provisão de serviços de saúde mental no setor de planos privados de assistência à saúde em relação à experiência internacional e ao Sistema Único de Saúde (SUS). O artigo demonstra que a assistência à saúde mental do setor apresenta as falhas associadas ao mercado de seguro saúde. As empresas de planos de saúde adotam mecanismos de copagamento, estabelecem limites de utilização para consultas ambulatoriais, enfatizam o tratamento dos casos graves por internação hospitalar de curta duração e oferecem residualmente serviços de suporte ao paciente após a alta. Existem evidências de um descompasso entre o processo de desinstitucionalização em curso no SUS e a regulação implantada pela ANS. Em fins da década de 2000, foi observada a expansão da quantidade das internações psiquiátricas que resultaram em taxas elevadas de admissão se comparadas ao setor público.
Palavras-chave:
Saúde Mental
Seguros de saúde
Planos de Saúde Pré-pagos
Brasil
Reforma Psiquiátrica
Abstract:
The article examines the regulatory regime of mental health care implemented by the National Health Agency (ANS). Describes the conditions observed between the provision of mental health services in the sector of private health care in relation to international experience and the Unified Health System (SUS). The article demonstrates that the mental health care provision by prepayment sector has the failures associated with the health insurance market. The health insurance companies have recourse to copayment mechanisms, set limits for outpatient use, emphasize the short length hospitalizations for the treatment of severe cases and residually offers support services to the patient after discharge. Since the late 2000 has been observed the expansion of the number of psychiatric hospitalizations that resulted in high rates of admission compared to the public sector.
Keywords:
Mental Health
Health Insurance
Prepaid Health Plans
Brazil
Psychiatric Reform
The article examines the regulatory regime of mental health care implemented by the National Health Agency (ANS). Describes the conditions observed between the provision of mental health services in the sector of private health care in relation to international experience and the Unified Health System (SUS). The article demonstrates that the mental health care provision by prepayment sector has the failures associated with the health insurance market. The health insurance companies have recourse to copayment mechanisms, set limits for outpatient use, emphasize the short length hospitalizations for the treatment of severe cases and residually offers support services to the patient after discharge. Since the late 2000 has been observed the expansion of the number of psychiatric hospitalizations that resulted in high rates of admission compared to the public sector.
Palavras-chave (keywords):
Mental Health
Health Insurance
Prepaid Health Plans
Brazil
Psychiatric Reform
Fagundes, P., COSTA, NR. Saúde Mental e os Planos de Saúde no Brasil.. Cien Saude Colet [periódico na internet] (2011/Set). [Citado em 06/10/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/saude-mental-e-os-planos-de-saude-no-brasil/8490?id=8490
