Healthcare financing, decentralization and regional health planning: federal transfers and the healthcare networks in Minas Gerais, Brazil

Moreira, Laura Monteiro de Castro; Ferré, Felipe; Andrade, Eli Iola Gurgel

doi:10.1590/1413-81232017224.28252016

Laura Monteiro de Castro Moreira

Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190/724, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil. laura.moreira@saude.mg.gov.br

Felipe Ferré

Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190/724, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil. laura.moreira@saude.mg.gov.br

Eli Iola Gurgel Andrade

Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190/724, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil. laura.moreira@saude.mg.gov.br

Collaborations

LMC Moreira worked on the conception and design of the study, data analysis and interpretation, writing of the paper and approval of the version to be published. F Ferré worked on the conception and design of the study, interpretation of data analysis, critical review and approval of the version to be published. EIG Andrade worked on the conception and design of the study, data analysis and interpretation, critical review and approval of the version to be published.

Expanded Health Region	Resident Population^*	Total Area (Km2)^**	Covered municipalities^**		Health Regions covered by socioeconomic and health conditions category – 2016^***					Nº of establishments by type of provider – 2014^****			Resolubility (%) ^*****

	2014		N	%	1	2	3	4	5	Public	Private	Philant.	2014
Central	6.480.169	58.120	103	12	1	1	5	2	1	1.897	8.215	75	99,53
South Central	780.011	15.811	51	6	-	-	3	-	-	479	1.371	35	59,90
Jequitinhonha	296.870	20.567	23	3	2	-	-	-	-	212	176	9	48,93
East	1.523.095	32.447	86	10	4	-	3	-	-	699	1.458	22	85,07
East of South	694.964	15.169	53	6	2	-	1	-	-	426	866	20	57,50
Northeast	931.946	56.641	63	7	6	1	1	-	-	627	639	29	61,86
Northwest	691.080	79.594	33	4	-	2	1	-	-	388	759	21	63,85
North	1.661.130	122.880	86	10	7	1	1	-	-	1.090	739	21	95,97
West	1.254.944	28.552	54	6	1	1	4	-	-	646	1.730	38	50,66
Southeast	1.651.433	24.665	94	11	1	-	6	-	1	956	1.998	62	97,04
South	2.755.109	53.766	153	18	1	-	8	1	2	1.624	4.789	161	96,45
Northern Triangle	1.260.398	42.784	27	3	-	1	1	-	1	408	1.786	17	96,02
Southern Triangle	752.948	35.535	27	3	-	-	1	1	1	391	769	22	97,62
Total	20.734.097	586.529	853	100	25	7	35	4	6	9.843	25.295	532	89,80

Expanded Health Region	2006 (US$R$ million)				2010 (US$ million)

	FAEC	MAC Limit	Networks	Total	FAEC	MAC Limit	Networks	Total	Variation 2006 -2010 (%)
Central	42.22	178.25	4.63	225.09	38.33	241.11	4.22	283.66	34.56
South Central	5.08	16.19	0.34	21.61	4.13	21.47	0.30	25.90	26.02
FES/MG	36.72	188.17	0.00	224.89	24.65	274.24	3.72	302.61	19.85
Jequitinhonha	0.00	0.00	0.04	0.04	0.00	0.00	0.07	0.07	66.22
East	6.24	24.63	0.98	31.85	6.46	35.56	0.89	42.91	34.72
East of South	3.76	8.92	0.04	12.72	3.61	13.60	0.04	17.24	35.57
Northeast	2.63	6.65	0.04	9.33	2.45	9.36	0.09	11.91	27.62
Northwest	2.15	8.01	0.43	10.59	1.71	10.40	0.33	12.43	17.35
North	6.01	27.87	0.70	34.58	3.50	38.49	0.37	42.36	22.51
West	4.35	14.40	0.21	18.97	3.76	17.75	0.50	22.01	16.04
Southeast	6.87	29.58	0.75	37.21	6.40	46.05	0.71	53.16	42.87
South	6.25	17.37	0.30	23.92	6.19	29.51	0.66	36.36	51.97
Northern Triangle	6.14	11.79	0.08	18.02	6.25	25.79	0.12	32.15	78.44
Southern Triangle	2.54	10.96	0.07	13.58	1.57	17.13	0.47	19.16	41.14
Total	130.98	542.80	8.62	682.40	109.02	780.44	12.47	901.93	32.17

Expanded Health Region	2014 (US$ million)

	FAEC		MAC Limit		Networks		Total		Variation 2010 -2014 (%)

Central	55.28		269.99		93.79		419.07		2.54
South Central	4.67		19.34		4.98		28.99		47.74
FES/MG	40.15		217.79		52.36		310.29		11.92
Jequitinhonha	0.00		0.33		0.47		0.80		1,017.37
East	8.89		40.49		11.35		60.73		41.53
East of South	4.43		16.93		2.42		23.77		37.86
Northeast	2.87		12.98		3.58		19.43		63.21
Northwest	2.14		10.34		1.87		14.35		15.44
North	8.44		41.21		9.88		59.53		40.53
West	4.54		17.40		3.60		25.54		16.03
Southeast	6.18		42.36		10.33		58.86		10.73
South	7.39		45.00		7.58		59.97		64.95
Northern Triangle	9.10		31.28		2.39		42.77		33.02
Southern Triangle	2.01		12.46		4.81		19.28		0.63
Total	156.09		777.89		209.41		1,143.39		26.77

Network	N. Ordinance	Types of incentives	2006	2010	2014	Total 2006 to 2014 (US$)

			Amount (US$)	Amount (US$)	Amount (US$)
Mother and Child Care Network Rede Cegonha (RCEG)	25	House of Pregnant Woman. Baby and New Mother. Normal Delivery Centers. Enable / Qualify Beds for High Risk pregnant women. Enable / Qualify Beds of the Conventional Neonatal and Kangaroo Intermediate Care Units. Enable / Qualify Beds of Neonatal and Adult types II and III ICU	-	-	15,838,822.21	44,235,718.36
Expanded Regions Covered - RCEG			-	-	12
Care Network for People with Disabilities (RDEF)	13	Dental Specialties Centers (CEO-RAPD). Specialized Rehabilitation Centers. Orthopedic Workshops	-	-	8,883,984.33	12,136,149.18
Expanded Regions Covered - RDEF			-	-	13
Oral Health Care Network (RSB)	25	CEO. LRPD	2,038,849.34	2,545,807.09	8,209,372.33	33,358,943.45
Expanded Regions Covered - RSB			13	13	13
Mental Health Network (RSME)	74	CAPS. Therapeutic Residential Services. Reception Units. Mental health bed service in General Reference Hospital	-	-	35,389,988.06	64,084,844.76
Expanded Regions Covered - RSME			-	-	13
Emergency Network (RUE)	125	SAMU. UPA. Enable / Qualify Clinical Back-up Beds. Enable / Qualify Adult or Infant Types II and III ICU Beds. Enabling of Coronary Intensive Care – UCO beds types II and III. Emergency Entrance Doors. Prolonged Care Beds	6,582,804.51	9,654,195.79	117,714,219.59	321,943,122.18
Expanded Regions Covered - RUE			6	8	12
Total*	262	-	8,621,653.85	12,200,002.87	209,412,899.28	523,388,681.38

[1] Collaborations

LMC Moreira worked on the conception and design of the study, data analysis and interpretation, writing of the paper and approval of the version to be published. F Ferré worked on the conception and design of the study, interpretation of data analysis, critical review and approval of the version to be published. EIG Andrade worked on the conception and design of the study, data analysis and interpretation, critical review and approval of the version to be published.

Brasil

Brasil

Healthcare financing, decentralization and regional health planning: federal transfers and the healthcare networks in Minas Gerais, Brazil

Abstract