Abstract
This paper aims to present a debate on the new Brazilian Primary Health Care (PHC) funding policy. We consulted the national and international literature, and we involved municipal, state, and federal PHC managers to develop the payment method. The proposed final model is based on weighted capitation, payment-for-performance, and incentive for strategic actions. Capitation is weighted by the socioeconomic vulnerability, demographic aspects, and municipal adjustment, the payment-for-performance consists of an entire set of 21 indicators, and incentives for strategic actions were facilitated from the maintenance of some specific programs. The results of the simulations pointed to low registration (90 million Brazilians) for the currently estimated coverage (148,674,300 Brazilians). Moreover, they showed an immediate increase in financial resources for 4,200 Brazilian municipalities. We observed that the funding proposal brings Brazilian PHC into the 21st century, points to the strengthening of PHC attributes, and materializes the principles of universality and equity of the Unified Health System.
Highlights
Resumo O objetivo desse artigo é apresentar um debate sobre a nova política de financiamento para Atenção Primária à Saúde (APS) no Brasil
Observa-se que a proposta do financiamento traz a APS brasileira para o século XXI, aponta para o fortalecimento dos atributos da APS e torna concreto os princípios de universalidade e equidade do Sistema Único de Saúde
Parâmetro de cadastro A transferência de recursos financeiros do componente de capitação ponderada considera o quantitativo de pessoas cadastradas em equipes de Saúde da Família ou equipes de Atenção Primária, ponderada por critérios de equidade
Summary
Erno Harzheim (https://orcid.org/0000-0002-8919-7916) 1 Otávio Pereira D’Avila (https://orcid.org/0000-0003-1852-7858) 1 Daniela de Carvalho Ribeiro (https://orcid.org/0000-0002-3055-0041) 1 Larissa Gabrielle Ramos (https://orcid.org/0000-0002-3441-0951) 1 Lariça Emiliano da Silva (https://orcid.org/0000-0001-7501-1095) 1 Caroline Martins José dos Santos (http://orcid.org/0000-0003-3384-2637) 1 Luis Gustavo Mello Costa (https://orcid.org/0000-0002-9678-0173) 1 Carlo Roberto Hackmann da Cunha (https://orcid.org/0000-0002-3545-5801) 1 Lucas Alexandre Pedebos (https://orcid.org/0000-0001-6663-352X) 1
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