Cadernos de Saúde Pública
versión impresa ISSN 0102-311X
NICOLETTO, Sônia Cristina Stefano; CORDONI JR., Luiz y COSTA, Nilson do Rosário. Inter-municipal health consortia: the case of Paraná State, Brazil. Cad. Saúde Pública [online]. 2005, vol.21, n.1, pp. 29-38. ISSN 0102-311X. http://dx.doi.org/10.1590/S0102-311X2005000100004.
Inter-municipal health consortia emerged in Brazil's Unified National Health System (SUS) policy in the late 1980s. Municipal health administrators adhered to this strategy with the aim of upgrading health services supplied to the population. This research analyzes the profile of such consortia in Paraná State, focusing on specialized medical care. Data were obtained from reports by the State Health Council and questionnaires sent to all 20 existing municipal health consortia. Governmental Decree no. 1,101 and data published in 2000 on the profile of the health system in Paraná were used as references. Of the 399 municipalities in Paraná State, 81.5% have joined municipal consortia. Specialists are allocated by municipalities (4.4%), the State government (13.6%), or Federal Government (12.8%); another 69.2% are hired by the consortia themselves. The supply of consultations with specialists is either insufficient or inadequately distributed, and there are flaws in the referral and counter-referral system. Municipal health consortia serve as viable instrument for expanding and increasing the capacity of municipalities to supply specialized care, although there is a need for well-defined criteria, planning, and improving of the referral and counter-referral system.
Palabras llave : Medical Specialties; Health Planning; Health Policy.