AVALIAÇÃO DO CUMPRIMENTO DE INDICADORES E DE CAPTAÇÃO DE RECURSOS FINANCEIROS EM UNIDADES DE SAÚDE DA FAMÍLIA DE CAMPO GRANDE (MS)

Abstract

The Previne Brasil Program (PPB), the current funding program for Primary Health Care (PHC) of the Ministry of Health, has generated doubts, uncertainties and controversies. The main fear of municipal managers, members of CONASS and CONASSEMS is the possible loss of health financial resources. In this model, the subsidy is given through four criteria: weighted capitation, payment for performance, incentive for strategic actions, and financial incentive based on a population criterion, added later. In the meantime, the Family Health Strategy (ESF) is the priority model of Primary Health Care (PHC). To strengthen the ESF, the municipality of Campo Grande-MS (CG-MS) has established, since 2020, a partnership with the Oswaldo Cruz Foundation (FIOCRUZ) through the Laboratory of Innovation in Primary Health Care (LIAPS). With the partnership, the Multidisciplinary Residency Programs in Family Health (RMSF) and Residency in Family and Community Medicine (RMFC) were incorporated. Therefore, studies are needed to assess the possible consequences of implementing the PPB and LIAPS, as fundraising may vary in different regions of the territory due to existing heterogeneity and the municipal strategies adopted. A pattern of concentration of gains or losses has not yet been found in the different regions of the country, therefore, this study compared the fundraising of the GC-MS PHC before and after the implementation of the PPB. Verified the performance and potential for expanding fundraising of all Family Health Units participating and not participating in LIAPS in relation to compliance with the PPB Indicators. This is a quantitative, observational, analytical, cross-sectional study, based on secondary data for the period from January 2018 to December 2022 from the Ministry of Health Information System (E-SUS), Egestor platform, from the National Health Fund (FNS) and information provided by the Campo Grande-MS Health Department (SESAU), used for checking the indicators. Data were submitted to analytical statistical analysis, through chi-square and Fisher's exact tests used to analyze associations between categorical variables. The Mann Whitney test was used to compare the teams of units with and without LIAPS, regarding the weighted capitation criteria. All analyzes were performed using the R program, with a significance level of 5%. The results revealed an upward trend in funding transfers, considering the period as a whole (2018 to 2022), suggesting a possible interference in the findings due to the prolonged transition period due to the Covid-19 pandemic. 10 After the analysis, it was found that in 2021 the significant statistical associations between health units with and without LIAPS were reduced. But, in 2022, the LIAPS units outperformed the others. The most relevant percentages of the LIAPS units were obtained in the payment-for-performance criterion referring to indicators 1, 3, 5,6 and 7. However, the municipality, between the period of 2020 and 2021, did not reach the goals proposed by the PPB agreement. When analyzing the viability of the Family Health Strategy after the implementation of the Ministry of Health's financing program, this study became relevant with an impact on it, because, in order for there to be continuous improvement in the management capacity and maintenance of health services, it is essential to analyze the criteria and parameters capitation of financial resources of the APS. In addition, a strategy for restructuring the USF in the municipality, the LIAPS, was evaluated, which boosted the increase in compliance with PPB indicators in the implanted units, probably due to the strengthening of essential and derivative attributes, the use of management tools of care, the qualification of practices through permanent health education and the implementation of the service portfolio. Actions with possibilities of immediate applicability in the other ESF. Descriptors: Innovation in Primary Health Care; Family Health Strategy; Prevent Brazil Program.