Analysis of Primary Health Care indicators and expenditures after changes in Federal Co-financing in the municipalities of Pernambuco, Brazil

Bibliographic Data

ID24216577
AuthorsValdecir Barbosa da Silva Júnior (0000-0002-0923-3869, Fundação Oswaldo Cruz), Garibaldi Dantas Gurgel Junior (0000-0002-2557-7338, Fundação Oswaldo Cruz)
Year2026
Volume31
Issue9
Publication date2026-01-01
Open AccessYes
TypeARTICLE
VenueCiência & Saúde Coletiva (JOURNAL)
Journal identifiersISSN: 1413-8123 • E-ISSN: 1678-4561
PublisherFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/1413-81232026319.14772025en
OpenAlexW7220367130
References cited19

The Previne Brasil program and the new 2024 methodology altered the federal co-financing of Primary Health Care (PHC) in Brazil. This study aimed to analyze the temporal trend of performance indicators and the number of registrations in PHC services and to compare the cost of PHC expenses from federal resources, after the co-financing changes, in the municipalities of Pernambuco. This is an ecological study with temporal trend analysis using Joinpoint regression, from 2018 to 2024. In this study, Pernambuco was used as an illustrative case to discuss the application of payment for performance (P4P) in universal systems. A growing trend was observed in registrations and performance indicators. A punctual reduction in federal funding was identified in 2021. After the discontinuation of Previne, the Union’s participation in the financing of PHC was greater. However, the challenge of overcoming evaluation models restricted to the process dimension persists, making it imperative to recover Donabedian’s triad and the essential attributes of primary health care to guarantee quality of the Unified Health System.

Brazilian health system · health care costs · Health care financing · performance indicators · performance-based pay · Pernambuco municipalities · Previne Brasil · Primary care · Healthcare Systems and Reforms · Primary Care and Health Outcomes · Public Health in Brazil

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