Repasses federais por emendas parlamentaresreconfiguração do financiamento municipal da saúde?

Resumo

Over the past eleven years, there has been a significant increase in the allocation of federal resources to the Brazilian Unified Health System (SUS) through parliamentary amendments, with municipalities being the primary beneficiaries of these allocations. In this context, one question is whether these transfers are associated with changes in the pattern of municipal health expenditures, evidenced by spending on public health actions and services (ASPS) and total health expenditure (THE). Accordingly, the objec-tive of this study is to investigate the association between federal transfers to SUS via parliamentary amendments and municipal health spending from 2015 to 2024. To this end, an analysis was conducted of the financial execution of parliamentary amendments by the Ministry of Health, specifically in the modality of transfers to municipalities; the budget execution of expenditures on ASPS and THE; and the association between the receipt of parliamentary amendments and municipal health spending. The 5,523 municipalities analyzed experienced an increase in amendment-related funding from R$ 1.6 billion in 2015 to R$ 21.1 billion in 2024 (a growth of 1,209%). During the same period, the combined expenditure on ASPS and THE by these municipalities rose by 43.6% and 55.3%, respectively. The association analysis revealed a very weak to weak direct correlation between per capita amendment funding and per capita total health expenditure, which means that the variables move in the same direction; a very weak direct correlation between per capita amendment funding and per capita ASPS expenditure; and a very weak inverse correlation between per capita amendment funding and the proportion of municipal resources allocated to ASPS, which indicates that the variables move in opposite directions. These findings were corroborated by regression analysis, which showed that per capita amendment funding has low predictive power for THE, and especially for per capita ASPS expenditure and ASPS allocation, considering the 5,523 municipalities analyzed. Thus, this study provides evidence that congressional amendments exerted limited influence on the health spending pattern of these municipalities between 2015 and 2024.

Ficha do documento

Tipo

Estudo

Ano

2026

Instituição

Ipea

Fonte

Repositório do Ipea

Idioma

Português

Acesso

Acesso aberto

DOI

10.38116/td3203-port

Identificador

oai:repositorio.ipea.gov.br:11058/20395

Licença

Licença Comum

Abrangência

Brasil

Temas

Políticas PúblicasFinanças PúblicasSaúde

Palavras-chave

Programas SociaisFinanciamento da assistência à saúdeAlocação de recursos para a atenção à saúdeEmendas parlamentaresGastos públicos com saúdeSistema Único de SaúdeH Public Economics::H5 National Government Expenditures and Related Policies::H51 Government Expenditures and HealthHealthcare financingHealth care rationingParliamentary amendmentsPublic expenditure on healthUnified Health System