Analysis of practical prices in the acquisition of medicines by the health consortia compared to municipal institutions in the period from 2017 to 2018

Objective: To identify whether the drug purchases made by the Health Consortia were more efficient, in economic terms, than the purchases made individually by the Municipal Institutions, for the years 2017 and 2018. Methods: Descriptive analysis of the sample, using the trend measures central, economic analysis and calculation of the economic percentage. Results: The values obtained showed efficiency in consortium purchases, reflected in the greater quantity acquired and the lower price practiced, for most of the items analyzed in the reference period. Conclusions: Purchases by Health Consortia provided more savings compared to purchases made by Municipal Institutions, proving to be an option to obtain economic resources for health.

Efficiency in hospital care in Brazilian capitals for the period 2014-2017

Objective: Analyze the level of efficiency of the hospital care in the Brazilian capitals and the Federal District between the years 2014 to 2017. Methods: The investigation method used was the Data Envelopment Analysis to estimate resource the resource efficiency levels. Results: The results indicate that there are differences in the level of efficiency of the state capitals and the Federal District, making it possible to develop the potential of inefficient units, in order to increase technical efficiency in hospital care. Conclusion: Analyzing the use of public resources helps to identify whether resources are being applied efficiently and when not, they signal the need for decision making that is more consistent with the reality of each capital.

Analysis of payment models applied to federal funding from the perspective of the Brazilian Health System

Objective: This study aims at identifying the payment methods existing in the Unified Health System referring to federal transfers to Primary Health Care (PHC) and Specialized Health Care. Methods: A quantitative and analytical study was carried out, developed in three stages: survey of all types of transfers from the Union; classification of each transfer category according to the types of payment methods and measurement of the participation of each payment methods, according to the financing components analyzed, in relation to the net values transferred. Results: Federal transfers were classified into seven payment methods. For PHC, in 2020, approximately R$ 21.7 billion was calculated, including resources destined for the pandemic, and R$ 20.9 billion without considering resources to face the COVID-19 pandemic. More than 50% of the amounts used were classified as capitation, in both cases. For specialized health care, in 2019, around R$ 48.5 billion were calculated, and in 2020 more than R$ 49.2 billion. For the two years, more than 70% of the funds were allocated to fee for service. Conclusions: This study allowed for an expansion in knowledge about the allocation of resources referring to transfers from the Union to states, the Federal District and municipalities. As the payment methods are related to productivity, access and quality of the health service, knowing and identifying the most appropriate payment methods for each situation contributes to the achievement of the goals and to the mitigation of eventual losses of efficiency in the healthcare systems.

Análise de preços praticados nas aquisições de medicamentos pelos consórcios de saúde em comparação com as instituições municipais para o período de 2017 a 2018 / Analysis of practical prices in the acquisition of medicines by the health consortia compared to municipal institutions in the period from 2017 to 2018

Objetivo: Identificar se as aquisições de medicamentos realizadas pelos Consórcios de Saúde foram mais eficientes, em termos econômicos, que as compras realizadas individualmente pelas Instituições Municipais, para os anos de 2017 e 2018. Métodos: Análise descritiva da amostra, empregando as medidas de tendência central, análise econômica e cálculo do percentual econômico. Resultados: Os valores obtidos mostraram eficiência nas compras dos consórcios, refletidos na maior quantidade adquirida e no menor preço praticado, para a maioria dos itens analisados no período de referência. Conclusão: As compras pelos Consórcios de Saúde proporcionaram mais economia em comparação com as compras realizadas pelas Instituições Municipais, mostrando-se como uma opção para obter economicidade dos recursos destinados à saúde.

Objective: To identify whether the drug purchases made by the Health Consortia were more efficient, in economic terms, than the purchases made individually by the Municipal Institutions, for the years 2017 and 2018. Methods: Descriptive analysis of the sample, using the trend measures central, economic analysis and calculation of the economic percentage. Results: The values obtained showed efficiency in consortium purchases, reflected in the greater quantity acquired and the lower price practiced, for most of the items analyzed in the reference period. Conclusion: Purchases by Health Consortia provided more savings compared to purchases made by Municipal Institutions, proving to be an option to obtain economic resources for health.

Eficiência nos atendimentos hospitalares nas capitais brasileiras no período de 2014-2017 / Efficiency in hospital care in Brazilian capitals for the period 2014-2017

Objetivo: Analisar o nível de eficiência dos atendimentos hospitalares nas capitais estaduais e Distrito Federal entre os anos de 2014 a 2017. Métodos: O método de investigação utilizado foi a Análise Envoltória de Dados para estimar os níveis de eficiência dos recursos. Resultados: Os resultados indicam que ocorrem diferenças no nível de eficiência das capitais estaduais e Distrito Federal, sendo possível desenvolver o potencial das unidades ineficientes, de forma que aumentem a eficiência técnica nos atendimentos hospitalares. Conclusão: Analisar o uso dos recursos públicos contribui para identificar se os recursos estão sendo aplicados de forma eficiente e, quando não, sinaliza para a necessidade de tomada de decisões mais coerentes com a realidade de cada capital.

Objective: Analyze the level of efficiency of the hospital care in the Brazilian capitals and the Federal District between the years 2014 to 2017. Methods: The investigation method used was the Data Envelopment Analysis to estimate resource the resource efficiency levels. Results: The results indicate that there are differences in the level of efficiency of the state capitals and the Federal District, making it possible to develop the potential of inefficient units, in order to increase technical efficiency in hospital care. Conclusion: Analyzing the use of public resources helps to identify whether resources are being applied efficiently and when not, they signal the need for decision making that is more consistent with the reality of each capital.

Análise dos modelos de pagamento aplicados ao financiamento federal na perspectiva do Sistema Único de Saúde / Analysis of payment models applied to federal funding from the perspective of the Brazilian Health System

Objetivo: Este estudo tem por objetivo identificar os modelos de pagamento existentes no Sistema Único de Saúde referentes aos repasses federais para a Atenção Primária à Saúde (APS) e a Atenção Especializada à Saúde. Métodos: Foi realizado um estudo quantitativo e analítico, desenvolvido em três etapas: levantamento de todos os tipos de repasse da União; classificação de cada categoria de repasse segundo os tipos de modelos de pagamentos; e mensuração da participação de cada modelo de pagamento, de acordo com os componentes de financiamento analisados, em relação aos valores líquidos repassados. Resultados: Os repasses federais foram classificados em sete modelos de pagamentos. Para a APS, em 2020, foram apurados R$ 21,7 bilhões, aproximadamente, incluindo os recursos destinados para a pandemia, e R$ 20,9 bilhões, sem considerar os recursos para enfrentamento da pandemia de COVID-19. Mais de 50% dos valores empregados foram classificados como capitação, em ambos os casos. Para a Atenção Especializada à Saúde, em 2019, foram computados em torno de R$ 48,5 bilhões e, em 2020, acima de R$ 49,2 bilhões. Para os dois anos, mais de 70% dos recursos foram destinados a pagamentos por procedimento. Conclusões: Este estudo permitiu a ampliação do conhecimento sobre a alocação dos recursos referentes aos repasses da União para estados, Distrito Federal e municípios. Como os modelos de pagamentos estão relacionados com a produtividade, acesso e qualidade do serviço de saúde, conhecer as formas de pagamento e identificar a mais adequada para cada situação contribui para o alcance das metas e para a mitigação de eventuais perdas de eficiência nos sistemas de saúde.

Objective: This study aims at identifying the payment methods existing in the Unified Health System referring to federal transfers to Primary Health Care (PHC) and Specialized Health Care. Methods: A quantitative and analytical study was carried out, developed in three stages: survey of all types of transfers from the Union; classification of each transfer category according to the types of payment methods and measurement of the participation of each payment methods, according to the financing components analyzed, in relation to the net values transferred. Results: Federal transfers were classified into seven payment methods. For PHC, in 2020, approximately R$ 21.7 billion was calculated, including resources destined for the pandemic, and R$ 20.9 billion without considering resources to face the COVID-19 pandemic. More than 50% of the amounts used were classified as capitation, in both cases. For specialized health care, in 2019, around R$ 48.5 billion were calculated, and in 2020 more than R$ 49.2 billion. For the two years, more than 70% of the funds were allocated to fee for service. Conclusions: This study allowed for an expansion in knowledge about the allocation of resources referring to transfers from the Union to states, the Federal District and municipalities. As the payment methods are related to productivity, access and quality of the health service, knowing and identifying the most appropriate payment methods for each situation contributes to the achievement of the goals and to the mitigation of eventual losses of efficiency in the healthcare systems.