Consórcios públicos de saúde na Bahia: trajetória e aspectos comparativos

Abstract

The federative decentralization, which initially occurred with the promulgation of the Federal Constitution of 1988, gave autonomy and administrative independence to the municipalities, but caused financial difficulties, especially the underfunding of health care. To face this reality, states and municipalities are making use of federative cooperation through public health consortia to provide public health services of medium and high complexity. Therefore, this work seeks to understand how the public health consortia contribute to regionalization and financing of public policies of medium and high complexity health services in Bahia, taking the previous experiences in Minas Gerais and Ceará as comparative cases. The research methodology used is qualitative descriptive, using the bibliographic and documental research as instruments of data collection and, to analyze the information extracted, it is used the content analysis, as a systematization technique. Through this, it could be observed that, the Public Health Consortia of Bahia meet the process of regionalization of health and are an alternative to the underfunding of health care in Bahia. In terms of institutional standardization, the Bahia CIS are similar to those of Minas Gerais and Ceará, only presenting small differences in relation to the state and municipal laws. As to the organizational structure, similarities are also presented in terms of the functioning of the consortia themselves, and this is stronger between the Ceará and Bahia CISs. The Bahian CIS present state capacity, reflected in the Regional Polyclinics. In public governance, the Bahian public health consortia form a public-public partnership between the state and the consorted municipalities of the health region, they are interfederative consortia (vertical), similar to that of Ceará and different from that of Minas Gerais (intermunicipal consortia - horizontal).