The new PHC 2024 federal resource allocation model: Variation in transfers in municipalities in São PauloABSTRACT
The authors verified which characteristics of Previne Brasil were perpetuated in the new Primary Health Care (PHC) resource allocation model and which innovations were introduced by the new ordinance. The financial analysis consisted of the results of Ordinance No. 3,493/2024, in comparison with the former Previne Brasil program (Ordinance No. 2,979/2019), in the 645 municipalities of the State of São Paulo. A comparative analysis was carried out of the average monthly amounts of federal resources transferred in 2022 via Previne Brasil and the 2024 installments (periods: May to September). Of the 645 municipalities analyzed, 98.5% (635 municipalities) had a positive variation. The least vulnerable municipalities presented average losses close to those of the other strata, but the average gains per municipality significantly exceed (5 times more) those of the most vulnerable municipalities. Specifically, the loss of resources in the Guarani Aquifer area may be directly related to the greater presence of Primary Care teams than Family Health teams. The new model of the federal government presents a combination of innovations aimed at greater coherence with the principles of the National Primary Care Policy and elements inherited from the Previne Brasil model that still reflect a managerial and market-oriented logic.
KEYWORDS
Health financing; Primary Health Care; Health care rationing; Unified Health System; Health care economics and organizations.