Abstract
The Brazilian Unified National Health System (Sistema Unico de Saude [SUS]) is in a prominent position compared to the existing social policies. One of the new tools used by SUS is known as Performance Index of the Unified Health System (Indice de Desempenho do Sistema Unico de Saude [IDSUS]), which is intended to measure the performance of each municipality. Therefore, the aim of this study was to propose a model of cost-effectiveness to compare IDSUS performance against total revenues achieved in Homogeneous Group 2, consisting of 94 municipalities and analysed using data from IDSUS and the System Information of the Public Budget for Health Care (Sistema de Informacao do Orcamento Publico em Saude [SIOPS]) for the year 2011. After structuring this data, we carried out descriptive statistical and cluster analysis in order to group similar municipalities in accordance with established variables: IDSUS performance, population and total revenue in health per capita. Even with the division of municipalities into homogeneous groups and after using variables such as population and revenue to regroup them, the results showed there are municipalities with heterogeneous characteristics. Another finding is in the use and intersection of two distinct databases (IDSUS and SIOPS), which allowed for visualizing the impact of health care revenue on the municipalities performance.
Highlights
One of the great achievements of Brazilian people, even in the 20th century, was the promulgation of the Constitution of the Federative Republic of Brazil in 1988 that has among others subjects, the social right as citizenship factor
From the rights achieved in the named Citizen Constitution, the health care social policy implemented in Brazil was the Brazilian Unified National Health System (Sistema Único de Saúde [SUS]) that has as main objectives universality, integrality, equal assistance, community participation and decentralization of single and centralized command
In this context of performance and economic evaluations on health care, as previously pointed out, this research proposes a cost-effectiveness analysis model for public health care policy adopted by SUS, using as variables public revenues for health care and scores achieved by municipalities in IDSUS, which will be specified soon
Summary
One of the great achievements of Brazilian people, even in the 20th century, was the promulgation of the Constitution of the Federative Republic of Brazil in 1988 that has among others subjects, the social right as citizenship factor. From the rights achieved in the named Citizen Constitution, the health care social policy implemented in Brazil was the Brazilian Unified National Health System (Sistema Único de Saúde [SUS]) that has as main objectives universality, integrality, equal assistance, community participation and decentralization of single and centralized command. In Brazil, access to public health care system as factor of citizenship was established only in 1988 with the promulgation of the Constitution, and has been treated as a right of the Brazilian citizen (Conselho Nacional de Secretários de Saúde, 2011; Finkelman, 2002; Santos, Francisco, Faria, & Gonçalves, 2011) Health care managers at all levels of the government must ensure the quality of their expenditure and the rationalization and reduction of costs”
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