Aten��o Prim�ria � Sa�de e Terceiriza��o: um estudo sobre as capitais brasileiras com base em indicadores / Primary Health Care and Outsourcing: a study of Brazilian capitals based on indicators

RESUMO

Este estudo focaliza o desempenho das capitais brasileiras e do Distrito Federal na Aten��o Prim�ria � Sa�de (APS), em 2008 e 2012, considerando a experimenta��o da terceiriza��o dos servi�os de aten��o b�sica mediante organiza��es sociais ou funda��es de direito privado, ou a manuten��o da gest�o e da provis�o mediante administra��o direta (AD). A metodologia consistiu em estudo explorat�rio e descritivo que se valeu de dados secund�rios de acesso livre e irrestrito que serviram para a constru��o de indicadores de caracteriza��o das cidades e de seu desempenho; pesquisa em s�tios eletr�nicos; coleta de dados mediante telefonema �s secretarias municipais de sa�de para identificar as cidades que tiveram ou n�o experi�ncias com a terceiriza��o dos servi�os de aten��o b�sica. A caracteriza��o das cidades tamb�m considerou dados demogr�ficos e socioecon�micos e indicadores de gastos governamentais na fun��o sa�de e com APS e a import�ncia do Fundo de Participa��o Municipal (FPM) nos or�amentos municipais.Para representar o desempenho selecionaram-se 19 indicadores, calculados para 2008 e 2012. Analisaram-se as medidas descritivas dos indicadores em 2012 e a sua evolu��o2008/2012, segundo as grandes regi�es do pais, relacionando a experi�ncia de terceiriza��o ou n�o da APS. Na an�lise da evolu��o 2008/2012 as informa��es foram agrupadas em categorias Cobertura e acompanhamento por equipes de AB, Sa�de da Crian�a, Sa�de da Gestante, Sa�de da Mulher, Condi��es de Sa�de Selecionadas e Sa�de Bucal.

ABSTRACT

This study focuses on the performance of the Brazilian capitals and the Distrito Federalin Primary Health Care, in 2008 and 2012, considering the outsourcing experiments of primary care services throught social organizations or private fundations or maintaining the management and provision by public administration. The methodology consisted of exploratory and descriptive study that made use of secondary data free and unrestricted access - that served to build indicators of characterization of cities and their performance, research on electronic sites; collection of data on call at municipal health departments to identify the cities that had or did not experience with outsourcing of primary care services.The characterization of the cities also considered demographic and socioeconomic data and government spending indicators in health and function with Primary Health Care and the importance of the Fundo de Participa��o Municipal (FPM) in municipal budgets. To represent the performance, 19 indicators were selectioned, and calculated for 2008 and2012. The descriptive measures were analyzed of the indicators in 2012 and its evolution 2008-2012, according to the major regions of the country, relating to outsourcing experience or not of Primary Healthy Care. Analyzing the changing 2008-2012 the information was grouped into categories Coverage and monitoring by primary careteams, Children's Health, Health Pregnancy, Women's Health , Health Status selected and Oral Health .