Autonomía financiera de establecimientos públicos y privados de salud en Brasil

Abstract Autonomy in financial management is an ad-vantage in public administration. A 2009 Na-tional Healthcare Facility Survey showed that 3.9% of Brazil’s 52,055 public healthcare fa-cilities had some degree of financial autonomy. Such autonomy was more common in inpa-tient facilities (17.8%), those managed by State governments (26.3%), and in Southern Brazil (6.6%). Autonomy was mainly partial (for re-sources in specific areas, relating to small out-lays, consumables and capital goods, and out-sourced services or personnel). 74.3% of 2,264 public facilities with any financial autonomy were under direct government administration. Financial autonomy in public healthcare facili-ties appears to be linked to local political deci-sions and not necessarily to the facility’s specific legal and administrative status. However, legal status displays distinct scopes of autonomy – those under direct government administration tend to be less autonomous, and those under pri -vate businesses more autonomous; 85.8% of the 45,394 private healthcare facilities reported that they were financially autonomous.Health Services Administration; Health Services Research; Financial Management