De Oliveira SE, Moysés NN. Comentando os dados referentes à capacidade instalada, força de trabalho e empregos de saúde. [Commentary on data referring to infrastructure, work force, and employees in health.] Saúde em Debate [Health in Debate] (Rio de Janeiro, Brazil) 2000; 24 (56): 35-43.

Objectives: To analyze data from the research project, “Medical-Healthcare Assistance,” carried out by the Brazilian national bureau of statistics in 1999 to measure progress in the country’s program of municipal decentralization.

Methodology: Analytical, based on secondary quantitative data.

Results: The research indicated that between 1992 and 1999 healthcare organizations expanded by 13%, reaching a total of 56,133 units. Of this total, 58.7% belonged to the public sector; 93% of this sector’s units did not involve hospital admissions. In the private sector, 22.4% entailed hospitalization. The public sector maintained 143,000 beds; the private sector, 341,000. The public sector employed 751,000 people, while the private sector employed 623,000. These data demonstrated the dominance of the public sector within the ambulatory network administered by the basic clinics, whereas the private sector accounted for more than 70% of hospitals and 80% of hospital admissions. Among healthcare institutions in 1999, 46.9% were public health centers, 26.1% were clinics and ambulatory care centers, 13.9% were hospitals or units offering mixed services, and 13.1% were centers offering diagnostic and/or therapeutic services.

The data also demonstrated that the public sector maintained centers throughout the country, while the private sector predominated in the southeastern and southern regions (an area of the country with greater purchasing power). In 1999, 71.3% of healthcare services (public and private) manifested some link to the Unified Healthcare System and 38.5% to private healthcare plans; 36.4% provided individualized, fee-for-service care.

The municipalities accounted for about 70% of public healthcare services.

Conclusions: In Brazil , despite the important expansion of the public sector with respect to infrastructure and provision of services, the Unified Healthcare System has remained highly dependent on services offered by the private sector.

Copyright 2007 University of New Mexico