Small hospitals and their insertion in Brazil's National Health System (SUS)

Abstract

This paper analyses small hospitals (less than fifty beds) in Brazil, in terms of their geographical distribution, legal status, types of wards and units, structures and service production. Under a directive published in April 2004, the Ministry of Health contracts and encourages these hospitals to adapt their profiles to the new roles assigned to them in the health system; consequently, data from December 2005 is compared to data from April 2004. Results: Small hospitals represent 62% of Brazil's hospital network, with 18% of current beds. Located mainly in upstate municipalities with less than 300,000 inhabitants, they offer limited complexity and technological density, with a low occupancy rate (32.8%). There are no changes in their production profiles between 2004 and 2006, due to the brief period since the implementation of Brazil's small hospitals policy in 2004, which has not been supported by the corresponding investment plans and human resources policies. This is a strategic hospital segment for providing all-round care in the Brazil's National Health System, due to its nationwide capillarity, endowed with ample potential for providing primary care while ensuring seamless links with other levels of complexity.