title: [Inter-municipal health consortia: the case of Paraná State, Brazil].
abstract: Inter-municipal health consortia emerged in Brazil's Unified National Health System (SUS) policy in the late 1980s. Municipal health administrators adhered to this strategy with the aim of upgrading health services supplied to the population. This research analyzes the profile of such consortia in Paraná State, focusing on specialized medical care. Data were obtained from reports by the State Health Council and questionnaires sent to all 20 existing municipal health consortia. Governmental Decree no. 1,101 and data published in 2000 on the profile of the health system in Paraná were used as references. Of the 399 municipalities in Paraná State, 81.5% have joined municipal consortia. Specialists are allocated by municipalities (4.4%), the State government (13.6%), or Federal Government (12.8%); another 69.2% are hired by the consortia themselves. The supply of consultations with specialists is either insufficient or inadequately distributed, and there are flaws in the referral and counter-referral system. Municipal health consortia serve as viable instrument for expanding and increasing the capacity of municipalities to supply specialized care, although there is a need for well-defined criteria, planning, and improving of the referral and counter-referral system.
authors.affiliation: 18 Regional de Saúde de Cornélio Procópio, Secretaria de Estado da Saúde do Paraná, Cornélio Procópio, Brazil. nicoleto@onda.com.br
authors.forename: Sônia Cristina Stefano
authors.initials: SC
authors.lastname: Nicoletto
authors.forename: Luiz
authors.initials: L
authors.lastname: Cordoni
authors.forename: Nilson do Rosário
authors.initials: Ndo R
authors.lastname: Costa
mesh_terms: D001938:Brazil; D003299:Cooperative Behavior; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007373:Interinstitutional Relations; D009096:Multi-Institutional Systems / Q000458:organization & administration* / Q000706:statistics & numerical data; D010347:Patient Care Planning; D011795:Surveys and Questionnaires