Navegando por Palavras-chave "Health Care Rationing"

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    Aplicações diretas para aquisição de medicamentos no Sistema Único de Saúde
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2011-10-01) Vieira, Fabiola Sulpino [UNIFESP]; Zucchi, Paola [UNIFESP]; Ministério da Saúde Secretaria Executiva Departamento de Economia da Saúde e Desenvolvimento; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To analyze resource allocation for pharmaceutical procurement by federative entities in the Brazilian Unified Health System. METHODS: The amounts allocated to purchase pharmaceuticals during 2009 in two information systems were analyzed: Siga Brasil (Follow Brazil) for national data and Sistema de Informações sobre Orçamentos Públicos em Saúde (Information System on Public Health Budgets) for states, the Federal District and municipalities data. Per capita spending and the mean and median spending were calculated by municipalities, according to region and population size. The Spearman correlation coefficient was calculated for some variables. The statistical analysis included tests of normality and multiple comparisons for differences between groups. RESULTS: In 2009 the total amount spent by the three spheres of government for purchase of medicines was approximately R$ 8.9 billion. States and the Federal District were the main players, accounting for 47.1% of the total amount spent in the health system. Some states had per capita spending well above the mean (R$ 22.00 per resident/year) and the median (R$ 17.00 per resident/year). There were differences in municipal spending by region. The mean per capita expenditure of municipalities with less than 5,000 residents was 3.9 times that of municipalities with over 500,000 residents. Municipalities with less than 10,000 residents had higher per capita spending than other municipalities. CONCLUSIONS: Economic aspects such as the scale of procurement and bargaining power may explain differences in per capita spending between federal entities, especially among municipalities. The study indicates inefficiencies in the use of financial resources to procure medicines in the Brazilian Unified Health System.
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    Setting priorities for mental health research in Brazil
    (Associação Brasileira de Psiquiatria - ABP, 2012-12-01) Gregório, Guilherme [UNIFESP]; Tomlinson, Mark; Gerolin, Jerônimo [UNIFESP]; Kieling, Christian; Moreira, Hugo Cogo [UNIFESP]; Razzouk, Denise [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Stellenbosch University Department of Psychology; University of Cape Town Department of Psychiatry and Mental Health; Universidade Federal do Rio Grande do Sul Hospital de Clínicas de Porto Alegre Department of Psychiatry; University of London Institute of Psychiatry, King's College Health Services and Population Research Department
    BACKGROUND: The main aim of this study is to review the agenda for research priorities of mental health in Brazil. METHODOLOGY: The first step was to gather 28 experts (22 researchers, five policy makers, and the coordinator) representing all mental health fields from different geographical areas of the country. Participants were asked to list what they considered to be the most relevant mental health research questions for the country to address in the next 10 years. Seventeen participants answered this question; after redundancies were excluded, a total of 110 responses were collected. As the second step, participants were asked to rank which questions were the 35 most significant. The final step was to score 15 items for each of the 35 selected questions to determine whether it would be a) answerable, b) effective, c) deliverable, d) equitable, and e) effective at reducing the burden of mental health. The ten highest ranked questions were then selected. RESULTS: There were four questions addressing primary care with respect to a) the effectiveness of interventions, b) matrix support, c) comparisons of different models of stepped care, and d) interventions to enhance identification and treatment of common mental disorders at the Family Health Program. The other questions were related to the evaluation of mental health services for adults and children/adolescents to clarify barriers to treatment in primary care, drug addiction, and severe mental disorders; to investigate the cost-benefit relationship of anti-psychotics; to design interventions to decrease alcohol consumption; and to apply new technologies (telemedicine) for education and supervision of non-specialists. CONCLUSION: This priority-setting research exercise highlighted a need for implementing investments at the primary-care level, particularly in the family health program; the urgent need to evaluate services; and policies to improve equity by increasing accessibility to services and testing interventions to reduce barriers for seeking mental health treatment.