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Analysis of the use and reimbursement for health services by beneficiaries of private plans in the Brazilian Unified Health System 2005-2017

Grant number: 20/14711-0
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): February 01, 2021
Effective date (End): January 31, 2022
Field of knowledge:Applied Social Sciences - Administration - Public Administration
Principal researcher:Flávia Mori Sarti
Grantee:Leonardo Moreira
Home Institution: Escola de Artes, Ciências e Humanidades (EACH). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

The present research project proposes an analysis of the patterns of use of the Unified Health System (SUS) by beneficiaries of private health plans, as well as to identify values necessary for reimbursement for services used by SUS. This is a quantitative study using information from the microdata base of the National Supplementary Health Agency (ANS), containing records of procedures performed for beneficiaries of private plans in SUS. The empirical strategy to be adopted in the study is based on estimation of regression models regarding the reimbursement values, in relation to the variables of sociodemographic characterization of the patients, as well as morbidity, type of procedure performed, geographical location and administrative sphere of the establishments. The definition of profiles of beneficiaries of private health plans with a higher level of use of the public health system and respective expenses should result in the definition of actions in public health policies in the context of the Ministry of Health and the Ministry of Economy regarding incentives and disincentives to be granted to individuals with health plans and to private enterprises that offer health plans in Brazil.

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