Atenção à saúde e as transformações no mercado de trabalho: uma análise em três ensaios

Abstract

In view of the complexity and robustness of the Unified Health System (SUS), constant improvement and deep understanding of how the system works is required. In this context, this thesis is composed of three essays. The first, strictly descriptive, briefly analyzed the construction of the SUS, addressing its beveridgian character and legal bases. The objective was to list the challenges of the system from a multilevel perspective. The second, investigated the existing demand pressures, incorporating the differential access to health services between formal and informal workers. The estimates made through the two-stage Negative Binomial Model confirmed the existence of the high opportunity cost and restrictions of access to the health system faced by the informal workers generating additional costs to the SUS. The third essay proposes the strengthening of Primary Health Care (PHC) through the use of Information and Communication Technologies (ICTs). The central objective was to estimate the relationship between the adherence of technologies in Basic Health Units (PHU) and the number of patients served. We also considered the weight of political actors in the articulation of demands and agendas, which could highlight policies favorable to digitalization or not. Two methodological strategies were used: Data Envelopment Analysis (DEA) and Propensity Score Matching (PMS). The results indicated that the UBS with the highest level of digitalization did not have high numbers of attendances, however, the most technological units were located in municipalities with greater political alignment.