Eficiência no gasto público com atenção básica: da capital aos pequenos municípios, quem gasta melhor?

Abstract

Objective: To relate public spending on Primary Care with the results delivered to the population in the form of medical consultations in municipalities of different sizes in the State of Rio Grande do Sul. Methodology: This is an ecological study conducted in Passo Fundo, RS, in 2024, targeting the 497 municipalities in the State of Rio Grande do Sul. The sample consisted of 20 municipalities, chosen for convenience. The selected municipalities included Porto Alegre, as the capital, in addition to one small, one medium, and one large municipality from each Health Macroregion, as defined in the Health Regionalization Master Plan of the State Health Department. The years analyzed were from 2013 to 2016. Secondary data were obtained from the DATASUS portal and the National Health Fund portal. Results: A better result of medical consultations per inhabitant per year was observed in smaller municipalities (1.65), whereas Porto Alegre had the worst result (0.71). Additionally, the cost per consultation (base 1) was significantly lower in small municipalities (35.54), while Porto Alegre again showed the worst result (89.41) among the cities studied. Conclusion: Smaller municipalities performed better than larger ones in terms of the number of medical consultations conducted and the cost of those consultations. The explanation for this result is multifactorial, with easier access to health services being one possible reason for this finding.