Evaluation of universal access to health care through the SUS health care in formation system: Brazil, 1995 and 1998

Abstract Objectives: this article evaluates the universality of access to health care through the Sistema Onico de Saúde (S US) through the access to different leveis of complexity in clinic and hospital facilities. Methods: the Ambulatorial and Hospital Information System data bank was used (SIA/S US and SIH/S US) as source of information. The universality was analyzed by indicators of coverage and concentration ofprocedures per inhabitant/ year, observing the access between 1995 and 1998 in Brazil's regions. Results: the results showed a decrease in the hospitalization and an increase in the ambulatorial productivity and in total expenditures on health care. However, the growth was not redistributive, remaining concentrated in the South and Southeast, especially when the procedures are more expensive/complex. Conclusions: the article concludes that, although there has been improvement in access to the system, especially for the primary health care, there is still work to be done to achieve compliance with the constitutional principies of universality and equity in health care in Brazil.

摘要 研究目的：本文通过评估巴西统一卫生系统（Sistema Único de Saúde, SUS）在临床与医院机构不同复杂度层级的医疗服务可及性，检验该系统医疗服务获取的普适性水平。
研究方法：本研究采用门诊与医院信息系统（SIA/SUS及SIH/SUS）作为数据来源，以人均年度医疗服务覆盖度与项目集中度作为普适性分析指标，考察1995至1998年巴西各地区的医疗服务获取情况。
研究结果：结果显示，住院服务量有所下降，门诊服务效率与医疗总支出均有所提升，但该增长并未实现再分配，医疗资源仍集中于南部与东南部地区，在高成本、高复杂度医疗服务场景中这一特征尤为显著。
研究结论：本文最终得出结论：尽管巴西医疗系统的服务可及性，尤其是基础医疗服务的可及性有所改善，但要实现符合宪法规定的医疗服务普适性与公平性原则，仍有诸多工作亟待推进。