Control de costos en salud: Experiencias en países de las Américas
Cost containment in health in the Americas
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s.d., 1990
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Keeping health costs under control: In recent years two phenomena afecting the Region have served to highlight the importance of controlling health costs
Versión en inglés en: Policy and Planning 5(4), 1990
Versión en inglés en: Policy and Planning 5(4), 1990
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Item Los altos costos de la atención de salud en el Brasil(s.d.)An analysis is presented of the changes that have occurred in Brazilian health sector expenditures in recent years, and of the factors that have favored the excessive growth of curative care at the expense of health promotion- in particular, the balance between the public and the private sector, and the role the public financing, and foreign medical technology, among others. The analysis focuses on the medical-hospital system in Brazil, given its importance as an essential supplier of health services, and on the National Institute of Medical Care and Social Welfare (INAMPS), the agency that under writes the major portion of medical and hospital expenditures. The first section outlines the general features of the fee system that was adopted by the INAMPS for payments to health service suppliers, as well as the basic standards that govern the work of this agency in the context of the Brazilian health system. Notable in this regard are the policy changes adopted in the early 1980s with a view to reducing costs. The second section examines the high cost of Brazilian health care with a discussion of the following topics: the role of the physicians, the INAMPS fee schedule, high technology in medicine, behavior and health costs, choice of services, excessive rates of cesarean deliveries, and physicians and the choice of technology. One of the principal conclusions is that the cost of health care isItem Building the health-economic case for scaling up the WHO-HEARTS hypertension control package in low- and middle-income countries(2022)[ABSTRACT]. Generally, hypertension control programs are cost-effective, including in low- and middle-income countries, but country governments and civil society are not likely to support hypertension control programs unless value is demonstrated in terms of public health benefits, budget impact, and value-for-investment for the individual country context. The World Health Organization (WHO) and the Pan American Health Organization (PAHO) established a standard, simplified Global HEARTS approach to hypertension control, including preferred antihypertensive medicines and blood pressure measurement devices. The objective of this study is to report on health economic studies of HEARTS hypertension control package cost (especially medication costs), cost-effectiveness, and budget impact and describe mathematical models designed to translate hypertension control program data into the optimal approach to hypertension care service delivery and financing, especially in lowand middle-income countries. Early results suggest that HEARTS hypertension control interventions are either cost-saving or cost-effective, that the HEARTS package is affordable at between US$ 18-44 per person treated per year, and that antihypertensive medicines could be priced low enough to reach a global standard of an averageItem Development of an investment case for obesity prevention and control: perspectives on methodological advancement and evidence(2018)[ABSTRACT]. This paper opens a discussion on the main features of an investment case for obesity prevention and control, by scanning available evidence on existing approaches and by highlighting contextual considerations and evidence for Latin America and the Caribbean. We call on researchers and analysts in the field to update and broaden existing methods of economic analyses to better reflect the multisectoral nature of an investment case for obesity prevention and control. We also identify research gaps and further work required to advance methods and evidence towards investment cases throughout the Americas.Item Cost of providing doctors in remote and vulnerable areas: Programa Mais Médicos in Brazil(2018)[ABSTRACT]. Objective. To evaluate the Programa Mais Médicos (More Doctors Program; PMM) in Brazil by estimating the proportional increase in the number of doctors in participating municipalities and the program costs, stratified by cost component and funding source. Methods. Official data from the 2013 edition of Demografia Médica no Brasil (Medical Demography in Brazil) was used to estimate the number of doctors prior to PMM. The number of doctors at the end of the fourth PMM recruiting cycle (July 2014) was obtained from the Ministry of Health. Cost components were identified and estimated based on PMM legislation and guidelines. The participating municipalities were chosen based on four criteria, all related to vulnerability. Results. The PMM provided an additional 14 462 physicians to highly vulnerable, remote areas in 3 785 municipalities (68% of the total) and 34 Special Indigenous Sanitary Districts. There was a greater increase of physicians in the poorest regions (North and Northeast). The estimated annual cost of US$ 1.1 billion covered medical provision, continuing education, and supervision/mentoring. Funding was largely centralized at the federal level (92.6%). Conclusion. The cost of PMM is considered relatively moderate in comparison to its potential benefits for population health. The greater increase of doctors for the poorest and most vulnerable met the target of correcting imbalances in health worker distribution. The PMM experience in Brazil can contribute to the debate on reducing physician shortages.