RELATION BETWEEN HEALTH EXPENSES,BASIC ATTENTION IN HEALTH EFFORTS INDEX AND HEALTH SYSTEM STRUCTURE TYPOLOGY OF THE MUNICIPALITIES OF SÃO PAULO STATE

ABSTRACT In a context marked by the re-democratization of the country and by the proposals of the State reform, the health area has stood out due to the advances in the decentralization process, the relevance of the social expenditure of counties in this function, and the expansion of the information systems. At the same time, the current model of public management by results has contributed to the use of social indicators in order to subsidize the decision process, although there still is the challenge of a joint evaluation of indicators of results/efforts, and the application of budgeted resources. The objective of this study was the presentation of a descriptive analysis based on the contrast of relationships among different categories of counties in the State of São Paulo, in terms of: expenditure in health with county-owned resources per inhabitant; transfers from Sistema Único de Saúde (SUS - governmental general health system) per inhabitant; typology of the health system structure, and ratio of basic attention to health effort. The last two items were created by Fundação Sistema Estadual de Análise de Dados (Seade - State System for Data Analysis Foundation), an agency belonging to the State of São Paulo. The analysis of the behavior of the four variables was carried out using Q-square and the correspondence analysis technique, and the main results were: connection between the basic attention efforts index and the expenditures with health using county-owned resources per capita, and low discrimination power among counties in relation to values of transfer of SUS resources.

摘要
在国家重返民主化进程与国家改革方案陆续出台的背景下，卫生领域凭借分权化进程的推进、各县在卫生领域社会支出的重要性，以及信息系统的扩容升级而备受关注。与此同时，当前的结果导向型公共管理模式推动了社会指标的应用以辅助决策制定，但仍面临两项核心挑战：需对结果与努力类指标开展联合评估，以及预算资源的落地应用。
本研究针对圣保罗州不同类别县域展开描述性分析，对比其多维度关联关系，具体考察维度包括：人均县级自有资金卫生支出、人均统一卫生系统（Sistema Único de Saúde，简称SUS）拨付资金、卫生系统结构分型，以及基本医疗服务与卫生投入的比值。其中后两项指标由隶属于圣保罗州的州数据分析系统基金会（Fundação Sistema Estadual de Análise de Dados，简称Seade）制定。
本研究采用Q平方检验与对应分析技术对四项变量的分布特征进行分析，主要研究结果如下：基本医疗服务投入指数与人均县级自有资金卫生支出存在显著关联；且各县在SUS拨付资金额度上的区分度较低。