Brazilian Private Health System: History, Scenarios, and Trends

2021 ◽  
Author(s):  
June Alisson Westarb Cruz ◽  
Maria Alexandra Viegas Cortez da Cunha ◽  
Thyago Proença Moraes ◽  
Felipe Francisco Tuon ◽  
Gisele de Paula Linhares ◽  
...  
Keyword(s):  
Mergers And Acquisitions ◽  
Health System ◽  
Secondary Data ◽  
Exploratory Research ◽  
Health Coverage ◽  
Operational Effectiveness ◽  
Public And Private ◽  
Health Networks ◽  
Business Plans ◽  
Unified Health System

Abstract Background: Health care is a complex economic and social system, which combines market elements and public and social interest. This combination in Brazil, like systems in China and America, is operationalized through the public and private system. The sector represents approximately 9% of the country's GDP, of which 56% is privately sourced and 44% is of public origin. In the private sector, supplementary health includes a structure with 711 hospital medical health plan operators, 47 million beneficiaries and revenues of US$30 billion a year. Methods: Therefore, this research describes and analyzes the complementarity of Supplementary Health before the Brazilian Unified Health System, highlighting its main characteristics, scenarios, and trends in the face of the health system and the Brazilian market. This descriptive and exploratory research uses secondary data from various sources, submitted to quantitative data analysis methods. The object of the research is the history of supplementary health in Brazil and its main actors. Results: The data are organized into three groups, each with its approach of collection and analysis. Thus, it is perceived as the notorious growth of large operators, to the detriment of operators with a lower concentration of beneficiaries; the increasing concentration of the market through mergers and acquisitions promoted by large publicly traded corporations, especially in regions with a lower rate of supplementary health coverage; and the growth of the sector through business plans, whose central characteristic is the dependence on the country's employability rate.Conclusions: It is possible to perceive an intense trend of concentration of Brazilian supplementary health in large institutions that have capitalized and have a great appetite for growth through mergers and acquisitions, whether from smaller operators or health institutions that integrate their health networks, following complementary health models already consolidated in countries such as China, and the United, among others. This concentration projects a market with fewer options and competitiveness, reduction in transaction costs and operational effectiveness of care.

scholarly journals Brazilian private health system: history, scenarios, and trends

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
June Alisson Westarb Cruz ◽  
Maria Alexandra Viegas Cortez da Cunha ◽  
Thyago Proença de Moraes ◽  
Sandro Marques ◽  
Felipe Francisco Tuon ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Mergers And Acquisitions ◽  
Health System ◽  
United States Of America ◽  
Secondary Data ◽  
The United States ◽  
Exploratory Research ◽  
Health Coverage ◽  
Health Institutions

Abstract Background Health care is a complex economic and social system, which combines market elements and public and social interest. This combination in Brazil, like systems in China and United States of America, is operationalized through the public and private system. The sector represents approximately 9% of the country’s GDP, of which 56% is privately sourced and 44% is of public origin. In the private sector includes a structure with 711 private health institutions, 47 million beneficiaries and revenues of US$30 billion a year. Methods Therefore, this research describes and analyzes the complementarity of Private Health before the Brazilian Unified Health System, highlighting its main characteristics, scenarios, and trends in the face of the health system and the Brazilian market. This descriptive and exploratory research uses secondary data from various sources, submitted to quantitative data analysis methods. The object of the research is the history of private health in Brazil and its main actors. Results The data are organized into three groups, each with its approach of collection and analysis. Thus, it is perceived as the notorious growth of large operators, to the detriment of operators with a lower concentration of beneficiaries; the increasing concentration of the market through mergers and acquisitions promoted by large publicly traded corporations, especially in regions with a lower rate of private health coverage; and the growth of the sector through business plans, whose central characteristic is the dependence on the country’s employability rate. Conclusions It is possible to perceive an intense trend of concentration of Brazilian private health in large institutions that have capitalized and have a great appetite for growth through mergers and acquisitions, whether from smaller operators or health institutions that integrate their health networks, following complementary health models already consolidated in countries such as China, and the United States of America, among others. This concentration projects a market with fewer options and competitiveness, reduction in transaction costs and increase the operational effectiveness of health care.

scholarly journals Changes in contraception use among Brazilian women after childbirth, 2006-2013

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Felisbino-Mendes ◽  
B Barrozo Siqueira
Keyword(s):  
Health System ◽  
Secondary Data ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Regional Inequalities ◽  
Unified Health System ◽  
Contraception Use ◽  
High Prevalence ◽  
Modern Methods ◽  
Low Prevalence

Abstract Introduction There are gaps in knowledge regarding the neglected and vulnerable subgroups of FP actions in Brazil, such as postpartum women and women in general, regardless of their marital status. Objective To assess changes in the prevalence of use and in the contraceptive pattern of Brazilian women up to two years after pregnancy, between 2006 and 2013. Methods Cross-sectional, descriptive and analytical study which used secondary data from national surveys. We studied Brazilian women with up to 2 years postpartum, of reproductive age, sexually active, non-pregnant and menstruating, and compared them with all the other women. We estimated the prevalence of use, contraception pattern of contraception and ranking of modern methods. Percentual change in indicators between the years was evaluated by calculating the difference between estimates. Results 85% of Brazilian women used CM, remaining stable in 2006 and 2013, with a high prevalence of modern methods use. An increase in the use of CM was observed among those with up to six months postpartum (71.0% to 89.0%). Pills and condoms accounted for about 60% of modern methods used in the postpartum period in both surveys. There was an increase in dual protection (2.9% to 10.1%) and contraceptive insecurity (1.6% to 5.7%) and a reduction in sterilization (16.2% to 13.4%) and traditional methods (2.1% to 1.4%). Conclusions Even with the maintenance of a high prevalence of use of CM and with the increase in contraception among women with up to six months postpartum, regional inequalities in access to CM and low prevalence of the use of other methods made available by the Unified Health System (SUS) persist, pointing out the maintenance of the insufficient care, failures in the means to regulate fertility and that public policies still hinder to guarantee the sexual and reproductive rights of the most vulnerable population. Key messages Regional inequalities in access to contraceptive methods and low prevalence of other methods made available by the Unified Health System (SUS) persist. There was an increase in contraception use among women with up to six months postpartum in Brazil.

scholarly journals Factors associated with conducting planning for secondary oral health care services in Brazil

2020 ◽  
Author(s):  
Edson Hilan Gomes de Lucena ◽  
Rênnis Oliveira da Silva ◽  
Carolina Dantas Rocha Xavier de Lucena ◽  
Amalia Issufo Mepatia ◽  
Yuri Wanderley Cavalcanti ◽  
...  
Keyword(s):  
Oral Health ◽  
Health System ◽  
Health Care Services ◽  
Service Management ◽  
Statistical Tests ◽  
Secondary Data ◽  
Chi Square ◽  
Factors Associated ◽  
Unified Health System ◽  
Service Production

Abstract Background: Planning in health services specifically aims to improve the health status of a given population, guaranteeing access with equity and justice, as well as streamlining the response of the health system to the needs perceived by the community. This research aims to identify the factors associated with planning Specialized Dental Clinics (SDCs).Methods: Secondary data were used from the external evaluation of the database of the first National Program for Access and Quality Improvement of SDCs (NPAQI–SDCs) and the informed Outpatient Information System of the Unified Health System (OIS/UHS), which contains data on the specialized dental procedures performed at SDCs. It consisted of a quantitative study in which Pearson chi-square statistical tests (p ˂ 0.05) and a multivariate logistic regression were applied with odds ratio (OR) estimate. Results: The results indicated that the realization of planning in SDCs was associated with lower coverage of the Oral Health Team of the Familiy Health Strategy in a municipality (OR = 1.4; 95% CI: 1.0-1.9, p = 0.049), additional training for managers (p = 0.038), the practice of self-assessment (OR = 8.2; 95% CI: 5.8-11.6; p = 0.000) and meeting service production targets (OR = 1.9; 95% CI: 1.2-3.2; p = 0.011). Conclusion: The results indicate that the work processes of the SDCs, especially with regard to service management, are essential to the proper functioning of the service and the practice of planning is linked to the technical capacity and commitment of service managers.

scholarly journals The Brazilian health system at crossroads: progress, crisis and resilience

2018 ◽  
Vol 3 (4) ◽  
pp. e000829 ◽  
Author(s):  
Adriano Massuda ◽  
Thomas Hone ◽  
Fernando Antonio Gomes Leles ◽  
Marcia C de Castro ◽  
Rifat Atun
Keyword(s):  
Health Outcomes ◽  
Health System ◽  
Health Resources ◽  
Secondary Data ◽  
Health Financing ◽  
Healthcare Services ◽  
Health Coverage ◽  
Structural Problems ◽  
Political Crises ◽  
Brazilian Health System

The Unified Health System (Sistema Único de Saúde (SUS)) has enabled substantial progress towards Universal Health Coverage (UHC) in Brazil. However, structural weakness, economic and political crises and austerity policies that have capped public expenditure growth are threatening its sustainability and outcomes. This paper analyses the Brazilian health system progress since 2000 and the current and potential effects of the coalescing economic and political crises and the subsequent austerity policies. We use literature review, policy analysis and secondary data from governmental sources in 2000–2017 to examine changes in political and economic context, health financing, health resources and healthcare service coverage in SUS. We find that, despite a favourable context, which enabled expansion of UHC from 2003 to 2014, structural problems persist in SUS, including gaps in organisation and governance, low public funding and suboptimal resource allocation. Consequently, large regional disparities exist in access to healthcare services and health outcomes, with poorer regions and lower socioeconomic population groups disadvantaged the most. These structural problems and disparities will likely worsen with the austerity measures introduced by the current government, and risk reversing the achievements of SUS in improving population health outcomes. The speed at which adverse effects of the current and political crises are manifested in the Brazilian health system underscores the importance of enhancing health system resilience to counteract external shocks (such as economic and political crises) and internal shocks (such as sector-specific austerity policies and rapid ageing leading to rise in disease burden) to protect hard-achieved progress towards UHC.

scholarly journals Factors associated with conducting planning for secondary oral health care services in Brazil

2020 ◽  
Author(s):  
Edson Hilan Gomes de Lucena ◽  
Rênnis Oliveira da Silva ◽  
Carolina Dantas Rocha Xavier de Lucena ◽  
Amalia Issufo Mepatia ◽  
Yuri Wanderley Cavalcanti ◽  
...  
Keyword(s):  
Oral Health ◽  
Health System ◽  
Health Care Services ◽  
Service Management ◽  
Statistical Tests ◽  
Secondary Data ◽  
Chi Square ◽  
Factors Associated ◽  
Unified Health System ◽  
Service Production

Abstract Background: Planning in health services specifically aims to improve the health status of a given population, guaranteeing access with equity and justice, as well as streamlining the response of the health system to the needs perceived by the community. This research aims to identify the factors associated with planning Specialized Dental Clinics (SDCs).Methods: Secondary data were used from the external evaluation of the database of the first National Program for Access and Quality Improvement of SDCs (NPAQI–SDCs) and the informed Outpatient Information System of the Unified Health System (OIS/UHS), which contains data on the specialized dental procedures performed at SDCs. It consisted of a quantitative study in which Pearson chi-square statistical tests (p ˂ 0.05) and a multivariate logistic regression were applied with odds ratio (OR) estimate. Results: The results indicated that the realization of planning in SDCs was associated with lower coverage of the Oral Health Team of the Familiy Health Strategy in a municipality (OR = 1.4; 95% CI: 1.0-1.9, p = 0.049), additional training for managers (p = 0.038), the practice of self-assessment (OR = 8.2; 95% CI: 5.8-11.6; p = 0.000) and meeting service production targets (OR = 1.9; 95% CI: 1.2-3.2; p = 0.011). Conclusion: The results indicate that the work processes of the SDCs, especially with regard to service management, are essential to the proper functioning of the service and the practice of planning is linked to the technical capacity and commitment of service managers.

scholarly journals Factors associated with conducting planning for secondary oral health care services in Brazil

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Edson Hilan Gomes de Lucena ◽  
Rênnis Oliveira da Silva ◽  
Carolina Dantas Rocha Xavier de Lucena ◽  
Amalia Issufo Mepatia ◽  
Yuri Wanderley Cavalcanti ◽  
...  
Keyword(s):  
Oral Health ◽  
Health System ◽  
Health Care Services ◽  
Service Management ◽  
Statistical Tests ◽  
Secondary Data ◽  
Chi Square ◽  
Factors Associated ◽  
Unified Health System ◽  
Service Production

Abstract Background Planning in health services specifically aims to improve the health status of a given population, guaranteeing access with equity and justice, as well as streamlining the response of the health system to the needs perceived by the community. This research aims to identify the factors associated with planning Specialized Dental Clinics (SDCs). Methods Secondary data were used from the external evaluation of the database of the first National Program for Access and Quality Improvement of SDCs (NPAQI–SDCs) and the informed Outpatient Information System of the Unified Health System (OIS/UHS), which contains data on the specialized dental procedures performed at SDCs. It consisted of a quantitative study in which Pearson chi-square statistical tests (p < 0.05) and a multivariate logistic regression were applied with odds ratio (OR) estimate. Results The results indicated that the realization of planning in SDCs was associated with lower coverage of the Oral Health Team of the Familiy Health Strategy in a municipality (OR = 1.4; 95% CI: 1.0–1.9, p = 0.049), additional training for managers (p = 0.038), the practice of self-assessment (OR = 8.2; 95% CI: 5.8–11.6; p = 0.000) and meeting service production targets (OR = 1.9; 95% CI: 1.2–3.2; p = 0.011). Conclusion The results indicate that the work processes of the SDCs, especially with regard to service management, are essential to the proper functioning of the service and the practice of planning is linked to the technical capacity and commitment of service managers.

scholarly journals COVID-19 hospitalizations in Brazil's Unified Health System (SUS)

2020 ◽  
Author(s):  
Carla Lourenço Tavares de Andrade ◽  
Claudia Cristina de Aguiar Pereira ◽  
Mônica Martins ◽  
Sheyla Maria Lemos Lima ◽  
Margareth Crisóstomo Portela
Keyword(s):  
Health System ◽  
Protective Factor ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Care Process ◽  
Independent Effect ◽  
Hospital Death ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Unified Health System

Objective: To study the profile of hospitalizations due to COVID-19 in the Unified Health System (SUS) in Brazil and to identify factors associated with hospital mortality related to the disease. Methods: Cross-sectional study, based on secondary data on COVID-19 hospitalizations that occurred in SUS, between the last days of February and June. Patients aged 18 years or older, with primary or secondary diagnoses indicative of COVID-19 were included. Bivariate analyses were performed and generalized linear mixed models (GLMM) were estimated with random effects intercept. The modeling followed three steps, including: attributes of the patients; elements of the care process; and characteristics of the hospital and place of hospitalization. Results: 89,405 hospitalizations were observed, of which 24.4% resulted in death. COVID-19 patients hospitalized in SUS were predominantly male (56.5%), with a mean age of 58.9 years. The length of stay ranged from less than 24 hours to 114 days, with a mean of 6.9 (STD=6.5) days. Of the total number of hospitalizations, 22.6% reported ICU use. The chances of hospital death among men were 16.8% higher than among women and increased with age. Black individuals had a higher chance of death. The behavior of the Charlson and Elixhauser indices was consistent with the hypothesis of a higher risk of death among patients with comorbidities, and obesity had an independent effect on increasing this risk. Some states had a higher risk of hospital death from COVID-19, such as Amazonas and Rio de Janeiro. The chances of hospital death were 72.1% higher in municipalities with at least 100,000 inhabitants and being hospitalized in the municipality of residence was a protective factor. Conclusion: There was wide variation in hospital COVID-19 mortality in the SUS, associated with demographic and clinical factors, social inequality and differences in the structure of services and quality of health care.

scholarly journals Collaborative and Structured Network for Maintenance of Mechanical Ventilators during the SARS-CoV-2 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 754
Author(s):  
Daniel Motta ◽  
Luiz Fernando Taboada Gomes Amaral ◽  
Bruno Caetano dos Santos Silva ◽  
Lucas de Freitas Gomes ◽  
Willams Teles Barbosa ◽  
...  
Keyword(s):  
Health System ◽  
Public Hospitals ◽  
Mechanical Ventilators ◽  
Public And Private ◽  
Health Crisis ◽  
The Public ◽  
Private Healthcare ◽  
Unified Health System ◽  
First Case ◽  
Rapid Deployment

The SARS-CoV-2 pandemic in Brazil has grown rapidly since the first case was reported on 26 February 2020. As the pandemic has spread, the low availability of medical equipment has increased, especially mechanical ventilators. The Brazilian Unified Health System (SUS) claimed to have only 40,508 mechanical ventilators, which would be insufficient to support the Brazilian population at the pandemic peak. This lack of ventilators, especially in public hospitals, required quick, assertive, and effective actions to minimize the health crisis. This work provides an overview of the rapid deployment of a network for maintaining disused mechanical ventilators in public and private healthcare units in some regions of Brazil during the SARS-CoV-2 pandemic. Data referring to the processes of maintaining equipment, acquiring parts, and conducting national and international training were collected and analyzed. In total, 4047 ventilators were received by the maintenance sites, and 2516 ventilators were successfully repaired and returned to the healthcare units, which represents a success rate of 62.17%. The results show that the maintenance initiative directly impacted the availability and reliability of the equipment, allowing access to ventilators in the public and private health system and increasing the capacity of beds during the pandemic.

Access to Diagnostic Services Through Health Insurance Schemes: Lessons from a Southern Indian State for Post-COVID Era

2021 ◽  
pp. 097206342110524
Author(s):  
Rajalakshmi RamPrakash ◽  
Joe Arun
Keyword(s):  
Health Insurance ◽  
State Government ◽  
Tamil Nadu ◽  
Secondary Data ◽  
World Health ◽  
Health Coverage ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Indian State

The ongoing COVID-19 pandemic has reiterated the importance of diagnostic services in ensuring public health of a nation. Access to timely diagnostic services can be limited because of non-availability and inability to pay, especially in lower-middle-income countries. The need for testing for COVID-19 and other diseases is likely to increase in the coming years. An innovative publicly funded health insurance scheme is being implemented in the southern state of Tamil Nadu, India since 2012 for providing financial protection and improving access to diagnostic services. Secondary data pertaining to empanelled public and private diagnostic centres, procedures covered, package rates and claims were procured from the state government and analysed. The article discusses the findings using the World Health Organization’s Universal Health Coverage framework. It argues that public policies providing health protection must explicitly include diagnostic services to fulfil the aim of leaving no one behind in the post-COVID world.

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