Health care financing, expenditure and supply in great urban centers in the state of São Paulo (Brazil)

Abstract

Challenges to implantation of SUS doutrinary and operative principles in great urban centers, have stimulated the developing of strategies focused on cities over 100.000 inhabitants and had raised researches on this setting. This article approaches health financing and expenditure evolution in São Paulo cities over 500.000 inhabitants, excluded the state capital, from 2000 to 2006. These data were compared with health services production. The main data sources were Seade Foundation, Siops and Datasus database. Conclusions pointed out to an increase in health expenditure higher than global income and expense increasing. The low PSF coverage and the increasing of middle and high complexity procedures production found in this study might reflect the tradictional medical-assistance model reproduction. Indicators dissimilarity presented by different cities bring up the necessity of case studies, as simple as multiple ones, in order to better understand and to identify the determinants of these differences.