Análise do impacto dos recursos financeiros, humanos e estruturais no desempenho da saúde no âmbito dos municípios do Estado do Ceará: uma análise dos anos de 2001 a 2011

Abstract

In recent years, in part by virtue of Constitutional Amendment 29, the Union managed the execution of part of health programs for municipalities and states, featuring a trend of reduced participation of the federal government in parallel with the increase of participation of States and municipalities, especially the latter. In accordance with this new redistribution of powers, the role of municipalities, especially those belonging to the poorest states in the country, has gained importance in the debate about the problems facing public health in Brazil. Although it is generally agreed that the underfunding of the public health sector is an impediment to compliance with the constitutional principles of universal access and comprehensive care, many of the problems that affect users of the SUS can be addressed through good management practices. Faced with the need to seek, in the application of scarce financial resources, a combination of inputs that produces the best results, the efficiency of public spending became part of the discussions of the Brazilian society, motivated primarily by the recognition of the scarcity of resources and the need to analyze the quality of those expenditures. It is necessary, therefore, to identify what types of expenditures and use of inputs related to health care have gotten better results for the municipalities, with the goal of replicating them to other group members, generating overall efficiency gains. This paper proposes to do this analysis in the context of the 184 municipalities in the state of Ceará in the period 2001 to 2011. For this analysis, the econometric methodology of Panel Data, which combines time series and cross-sectional data was used, the which results in a larger number of observations, or pooling data from various time periods for each individual, providing more informative data more variability less collinearity amongst variables, the more degrees of freedom and more efficiently. Empirical evidence indicates that current expenditures have immediate positive impacts, while investment expenditure impact after three years, higher than the impact of current expenditures. Expenses borne from its own resources to show the upper borne with funds transferred by the Union and state positive impact. With respect to physical inputs and human health, it was found that the impact analysis should not be viewed in isolation, but integrated.