Custeio da atenção primária à saúde nos municípios da região sudoeste do estado de Minas Gerais: um estudo sobre o centro de resultado Estratégia Saúde da Família sob a ótica do risco financeiro operacional da atividade

Abstract

Health in Brazil has as a milestone its inclusion in the Constitution of 1988, which gives the Brazilian people guaranteed access, a fact that led to the creation of the Unified Health System (SUS), which is organized from the Primary Attention to health Care (PHC) and to facilitate the population's access to health services network, the Family Health Strategy (FHS) was created. From studies that indicate failure of federal and state funding for this type of health service, it was verified that the municipalities are responsible for much of the funds invested in the FHS. This study is classified as exploratory-descriptive with a quantitative approach, and it was designed to measure implicit operational risk in the financial operations of the Family Health Strategy for the municipalities in the southwestern region of Minas Gerais. To achieve this goal, several research techniques were used. One of the most used techniques was the documentary research that served to identify and classify the ESF's in the municipalities of southwestern region of Minas Gerais. Regarding the number of teams, professionals and specification of the population served, and also to identify and measure the revenues and expenditures of the ESF's in the municipalities, and thus, identify the participation of each entity of the federation in its funding. To classify the ESF 's in relation to their APS basic characteristics, it was used a field research which had as an instrument, the Brazil - PCATool form, applied to the coordinators of the APS's / FHT's in each municipality. Finally, to gauge the operational financial risk in the ESF's municipalities surveyed, the results of documentary and field research were confronted with the law and previous research. The research results found showed that the expenses for maintenance of the ESF's activities in the municipalities surveyed, are distributed as follows: 52.07% Union, State of Minas Gerais 3.91% and municipalities surveyed in the Southwestern Region of Minas Gerais 44,03%. The expenses recorded amplitude of 71.51%. That is, expenditures of the municipalities surveyed in the ESF's, in the period between 2010 and 2012 ranged from 1.79 % to 73.30 %. These resources have been consumed as follows: Manpower (staff) 88.69%, 6.17% consumables and related services 5.14 %. The average expenditure per capita, per capita serviced (average per capita), in the ESF's municipalities surveyed in the years 2010, 2011 and 2012 were respectively: R$ 110.11, R$ 131.76 and R$ 155.46. About meeting the characteristics of APS, from the application of PCATool - form Brazil, the field research has shown that the municipalities surveyed in the southwestern region of the state of Minas Gerais, scoring from 1-4, reached 3.47. Therefore it is possible to infer that the municipalities surveyed meet the characteristics of APS. Results confirmed with the rate of compliance with the agreed targets, with the State Department of Health of Minas Gerais State, through the Home Health Program, and also by the rate of population coverage reaches results above the state and national average income. The operating financial risk reflects the quality of services provided by this health policy and its planning level. Before such a scenario, it is necessary to implement the planning and operational risk management policy, from the planning tools required for municipalities, Municipal Health Plan, Multi-Year Plan, the Budget Guidelines Law and Annual Budget Law. Dividing the practice areas of Municipal Health Secretaries in centers or investment income you can contribute so that the governmental actions can achieve effectiveness.