Public-Private Relationship in the Brazilian Policy of Tertiary Care for Cardiovascular Conditions

Abstract

Cardiovascular chronic non-transmitted diseases (DCNTs) are the major cause of mortality in Brazil, in addition to having the costliest treatment for the National Unified Health System (SUS). In this context, the objective is to evaluate the public-private relationship in the scope of the National Tertiary Care Policy for Cardiovascular Conditions (PNACAC) regarding regional access to procedures of high complexity in cardiology and the cost of these procedures from 2008 to 2015. It was used, to that end, IDSUS No. 9, adapted to contain regional results and limited to the procedures contained in PNACAC. The results showed that: (i) hospitalizations in private institutions financed by the SUS surpassed those that occurred in public hospitals, in all years for all Regions, except for the North; (ii) it is more expensive for the SUS to finance hospitalizations in private hospitals than in public hospitals; and (iii) IDSUS adapted from the Northern Region indicated that residents had greater access to SUS (public hospitals more private) when compared to the other Regions. It was concluded that the public-private relationship, within PNACAC, did not guarantee equitable access to the procedures for the review period, and that it appears to have been inefficient.