Abstract
Abstract This article adopts institutional collective action (ICA) to verify the difference in collective effects when observing inter-municipal cooperation arrangements to provide public health in Brazil (public health consortia). The study compares municipalities that joined consortia in 2009/2010 and municipalities that did not join until 2015. The analysis estimated collective effects of public health consortia and how they relate to contextual variables of policies in this area in the country. The methodology is longitudinal-retrospective deductive research, using the difference-in-differences statistical technique. The results show that municipalities engaged in local inter-municipal cooperation to provide public health in Brazil improved the services in terms of outpatient appointments and the number of primary health care (PHC) consultations, as well as reducing infant deaths.
Highlights
This article verifies the difference in collective effects between Brazilian municipalities that joined inter-municipal cooperation arrangements to provide public health – public health consortia – in 2009/2010, and the municipalities that did not join until 2015, adopting the institutional collective action (ICA) framework
Fiscal and structural characteristics were included in this model, contributing to explain the influence of the health consortium in the number of outpatient services (Table 1): TABLE 1 REGRESSION – NUMBER OF OUTPATIENT APPOINTMENTS – 2005/2015
The results infer that municipalities that joined public health consortia in 2009/2010 increased the number of primary health care (PHC) consultations significantly compared to municipalities that did not join one
Summary
This article verifies the difference in collective effects between Brazilian municipalities that joined inter-municipal cooperation arrangements to provide public health – public health consortia – in 2009/2010, and the municipalities that did not join until 2015, adopting the institutional collective action (ICA) framework. The dissemination of inter-municipal cooperation arrangements in the country is attributed to the Law on Public Consortia, enacted in 2005 (Abrucio & Sano, 2013). It was in 2009 and 2010, according to the National Confederation of Municipalities (Confederação Nacional dos Municípios [CNM], 2018), that the highest number of municipalities joined these initiatives to provide services in health. Observing the end of 2015 shows the differences between the two groups with enough time for the treatment group to be exposed to the experience of public health consortia
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