Acessibilidade / Reportar erro

Mobile Emergency Care Service (SAMU): underfunding and regional inequality

Abstract

Introduction

The implementation of the Mobile Emergency Service (SAMU) with the definition of investment and defrayal of costs represented an important advance in the Unified National Health System, in view of the morbidity and mortality rates related to emergency services in Brazil.

Methods

The research was based on the Public Health Budget Information System (SIOPS). Data were analyzed according to the National Health Accounts model of the World Health Organization.

Results

The participation of the SAMU in federal funding block of Medium and High Complexity (MAC) passed from 3.27% in 2009 to 6.67% in 2012, reaching 200 million Brazilian reais in the state of Bahia. The increase of 110% in this period occurred despite the negligible growth of MAC contributions. Half of the health regions did not present specific financial transfer records, indicating an unequal distribution of this important service, expressed in the accounts. The municipal expenditure per capita varied between R$ 103.04 and R$ 5.47, with the highest values directed to small towns. This difference is not justifiable from the standpoint of the cost of service offer.

Conclusion

Underfunding and regional inequalities require distributional adjustments and continuous evaluation in order to avoid that people be deprived of access to the protection guaranteed by the National Policy of Attention to Emergencies.

Keywords:
health expenditures; emergencies; emergency medical services

Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro Avenida Horácio Macedo, S/N, CEP: 21941-598, Tel.: (55 21) 3938 9494 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@iesc.ufrj.br