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Crisis and federalism: trends and regional patterns of health revenues and expenditures in the brazilian states

Titulo Crisis and federalism: trends and regional patterns of health revenues and expenditures in the brazilian states
Autoría Contarato PC, Lima LD, Leal RM.
Fuente Cien Saude Colet 2019 Cien Saude Colet. 2019 Dec;24(12):4415-4426. doi: 10.1590/1413-812320182412.25302019. Epub 2019 Aug 29. 10.1590/1413-812320182412.25302019
Resumen This study aims to analyze regional trends and patterns of health revenues and expenditure in the Brazilian states from 2006 to 2016. This is an exploratory and descriptive study based on secondary national data and selected indicators. Higher per capita net current revenues for all states and regions, with decreasing levels in specific years associated with the crises of 2008-2009 and 2015-2016 were observed. Per capita health expenditure showed an increasing trend, even in times of economic crisis and declining collection. Diversity of sources and heterogeneity of health revenues and expenditures, as well as different impacts of the crisis on the regional budgets, were observed. The results suggest the protective effect of constitutional health linkage, spending commitments and priorities, and compensation mechanisms of fiscal federalism revenue sources in state health expenditures. However, challenges remain for the implementation of a transfer system that reduces inequalities and establishes greater cooperation among entities, in a context of austerity and strong public health financing constraints in Brazil.
URL www.ncbi.nlm.nih.gov/pubmed/31778492