Regionalização como estratégia de universalização do SUS

Abstract

The discussion on access to health services is very important, since difficulties encountered in health care can affect people's quality of life. Since its creation, SUS has undergone several transformations, such as hierarchization and regionalization, in order to reduce geographic and social inequalities in access to health services. The hypothesis of the thesis refers to the probable existence of excessive displacements of patients between regions associated with the centralization of services in large urban agglomerations. The objective of this work is to characterize the Brazilian public health network in an attempt to answer whether the criteria applied for the SUS regionalization meet the principles of universality and wholeness as determined by the legislation, with the expansion of the coverage of health services. A theoretical discussion will be held on universality, health systems and regional policies to support the standards used by SUS. Municipal panel data for the years 2010-2015 will be used to characterize SUS and to perform an estimation of fixed effects, in order to verify the main determinants of municipal expenditure per capita in health. The conclusion is that, despite regionalization, the universalization of SUS is still a dream for the population of smaller municipalities, being necessary criteria beyond the economical ones if it is wanted to improve the distributive aspect of the system.