The trend, problems discovered, and enlightenment to hospital management of medical insurance fund unannounced inspection / 中华医院管理杂志

The rational use of medical insurance fund(MIF) plays an important role in promoting the high-quality development of public hospitals, and the supervision of MIF is in a trend of under the rule of law, normalization, professionalization and standardization, and unannounced inspection will become the norm. The authors systematically analyzed three main trends of MIF unannounced inspections, namely, gradually increasing intensity, constantly innovating methods, and increasingly serious consequences. The problems exposed in unannounced inspections were sorted out from five dimensions: form of results, severity, scope of attribution, subjective intention, and regulatory screening ideas. The enlightenment of MIF unannounced inspections to hospital management was explored from four aspects: compliance awareness, organizational system, fine management, and daily supervision. It was proposed that public hospitals should transform their roles and positions, improve the working mechanism of departmental collaboration, and achieve fine management in policy understanding, system formulation, process design, information support, data governance, regulatory implementation, personnel training, and performance matching. At the same time, internal simulated unannounced inspections in hospitals should be regarded as a routine work.

Analysis of Subject Related Costs in Medical Research / 中国医学伦理学

The development of medical research is completed by the cooperation of sponsors, investigators, subjects, and ethics committees. Clinically, it mainly includes clinical trials of medical devices, clinical medicine and new technology research. This paper analyzed the game and the relationship between rights, responsibilities and interests of relevant parties in medical research, combined with the relevant costs and sharing principles involved in medical research, and found that the use of the word "free" in the informed consent is easy to cause misunderstanding and the lack of relevant compensation costs in the informed consent, while the compensation and insurance costs had some problems, such as the imperfect subject compensation mechanism and the insufficient insurance purchase by the sponsor, which can not protect the basic rights and interests of the subjects. Therefore, in order to standardize the cost management of clinical medical research, it is necessary to standardize the process and content of informed consent, strengthen the supervision of medical research process, establish medical research damage compensation fund and research damage insurance system, so as to better protect the rights and interests of subjects.

Analysis on Basic Medical Insurance Fund Balance Status and Risk Warning in China from 2009 to 2022 / 中国卫生经济

Objective:To analyze the basic medical insurance fund balance status in China and the risk warning since the new medical reform,in order to provide decision-making references for the sustainable development of basic medical insurance fund in China.Methods:Collecting the data on the basic medical insurance fund in China from 2009 to 2022 for descriptive statistical analysis,and conduct fund balance risk warning analysis based on the risk warning interval.Results:During 2009-2021,the percentage of retirees enrolled in UEBMI has continued to increase,and there will still be a certain accumulated balance in the integrated fund.The number of participants in the URBMI has been decreased since 2020,the growth rate of fund expenditures became higher than the growth rate of fund revenues,the fund balance showed a decreasing trend.Conclusion:There are certain risks to the long-term balance of the basic medical insurance fund,which may caused by factors such as aging population,funding mechanisms,and treatment levels.

Model Construction Research on Digital Supervision of Medical Insurance Fund from the Perspective of Public Value Creation / 中国医院管理

Digital supervision of the medical insurance fund is the process of using digital information technology to map real-world medical scenarios and activities into the digital world,in which the medical insurance fund is super-vised and managed.The objectives of digital supervision include not only ensuring the safe and rational use of the medical insurance fund,but also promoting the quality of medical services,safeguarding the public's rights and interests,ensuring the long-term sustainability of the medical insurance system,and promoting social equity and stability at multiple levels.Based on the theory of Public Value theory,it interprets and explores the model and critical path of digital supervision of China's medical insurance fund from the three dimensions of Public Value Proposition,Autho-rizing Environment,and Operational Capacity,which concludes that the key to digital supervision of medical insurance funds lies in the search for consistency and balance between the three of real-world value objectives.Digital regulation should be oriented towards public value creation and return to value rationality;strengthen institutional design and build a pluralistic governance pattern for digital regulation;and strengthen core capacity building to make up for the shortcomings of digital regulatory capacity.The public value of digital supervision should be created from three as-pects:concept optimization,support and guarantee,and capacity improvement.The public value of digital supervision should be created from three aspects:concept optimization,support and guarantee,and capacity improvement.

Quality Research on the Dilemma of Supervision of Medical Insurance Funds and Response Strategies un-der Differential Medical Care / 中国医院管理

Objective To analyze the dilemma of medical insurance fund regulation under cross-location medical treatment in China,and put forward coping strategies to provide theoretical reference and reference for enhancing the efficiency of cross-location medical treatment regulation in China.Methods A systematic search was conducted to retrieve the literature related to the regulation of health insurance funds under off-site medical care from the time of database construction to December 2023 NVivo 12 Plus software was used to code and analyse the included litera-ture.Results 38 Articles were finally retained for qualitative research through searching and screening.Fifty-three ini-tial concepts,18 initial categories and 5 main categories were extracted,and the dilemma nodes of the supervision of cross-district medical fund in the dimensions of incomplete supervision mechanism,imperfect supervision law,single supervision means,insufficient capacity of supervision subject and moral risk of supervision object and moral risk of supervision object were obtained,insufficient capacity of the regulatory body and moral risk of the regulatory object.Conclusion The supervision of medical insurance fund under the cross-location medical care is constrained by many factors,and the soundness of the supervision mechanism is the core issue;the completeness and effectiveness of the supervision law is the important basis for supervision;the innovation of the supervision means and the promotion of the improvement of the effectiveness of the supervision are the important means of the supervision of the medical insurance fund under the cross-location medical care;and the restriction of the moral hazards of the institutions in the place of medical care and of the insured persons is the key link of the super-vision process.

Analysis of Public Willingness to Participate in Medical Insurance Fund Supervision Based on Weiner Attri-bution Theory / 中国医院管理

Objective To understand the public's willingness to participate in the supervision of medical insurance funds and their influencing factors,and to provide suggestions and references for creating a good atmosphere for the whole society to consciously pay attention to and maintain the safety of medical insurance funds.Methods Using a combination of non-proportional and convenience sampling with stratified sampling,a total of 1661 samples were collected from 28 provinces across China,and a chi-square test and binary logistic regression were used to investi-gate the factors affecting the public's willingness to participate in the supervision of medical insurance funds.Results There are 1661 valid questionnaires returned and a total of 457(27.51%)members of the public are willing to participate in supervision.The educational level in the ability dimension was the hindering factor of the public's supervision willingness(P＜0.001).Evaluation of the nature of medical insurance fraud and evaluation of the overall harm caused by medical insurance fraud in the dimension of effort,whether family members have medical insurance workers and whether they have the experience of obtaining medical assistance in the dimension of opportunity was the promoting factor of public supervised willingness(P＜0.05).Conclusion The public's willingness to participate in the supervision of medical insurance funds needs to be improved.It can focus on enhancing the public's willingness to supervise medical insurance funds from the dimensions of ability,effort and opportunity,deepen the public's aware-ness of medical insurance fraud,and continuously improve the public's enthusiasm to crack down on medical insurance fraud,and reduce and eliminate insurance fraud.

Fundos especiais e o esporte: histórico, legislação e produção do conhecimento / Special funds and sport: history, legislation and knowledge production

Este estudo se caracteriza como uma pesquisa documental e bibliográfica que objetivou analisar o percurso histórico, o arcabouço legal e a produção do conhecimento relativa aos fundos para o esporte no Brasil. Instituídos desde o Brasil Colonial, os fundos especiais são instrumentos de financiamento público que se disseminaram no país de maneira difusa e que possibilitam a vinculação, em lei, de determinadas receitas à despesas específicas. No setor esportivo, verificamos que tanto os fundos de esporte como mecanismo de financiamento, quanto a produção científica relativa aos fundos para o esporte são escassas. Considerando a discussão relativa à instituição de fundos nas três esferas federais, diversos desafios são levantados para o setor esportivo e para a solidificação do direito a prática esportiva no país a partir deste instrumento de financiamento público.

This study is characterized as a documentary and bibliographical research that aimed to analyze the historical course, the legal framework and the production of knowledge related to funds for sport in Brazil. Established since Colonial Brazil, special funds are public financing instruments that spread throughout the country in a diffuse way and that make it possible to link, by law, certain revenues to specific expenses. In the sports sector, we found that both sports funds as a financing mechanism and scientific production related to sports funds are scarce. Considering the discussion regarding the institution of funds in the three federal spheres, several challenges are raised for the sports sector and for the solidification of the right to practice sports in the country based on this public funding instrument.

Analysis of compliance issues and management countermeasures of medical insurance fund in clinical research / 中华医学科研管理杂志

Objective:Clinical research is widely carried out in medical institutions, and there are differences in the use of research and conventional medical funds. This paper aimed to analyze the compliance issues of insurance fund in clinical research and explore the management strategies in the institutions conducting clinical trials or research.Methods:By consulting the literature, questionnaire, and work practice, this paper analyzed the current situation and existing problems of the compliance of the medical insurance fund in domestic clinical trials, proposed targeted management measures for the use of funds, and standardizes the corresponding workflow.Results:This paper summarized three payment methods of research-related funds and analyzed the main problems at present, including the definition of trial requirements, the payment of combined drugs specified in the protocol, the particularity of medical device trials, the payment of adverse events in clinical trial, the insurance of post-marketing research and clinical trial. According to the regulatory requirements and work practices, the corresponding management countermeasures were sorted out, including that the project funds and insurance audit should be carried out inside the medical institution. Clinical research, medical insurance management departments, ethics committees, and other departments should collaborate on establishing and improving a compliance management system. The research team should strengthen the management of adverse events, strengthen the publicity and education of the participants, and make good use of the sharing platform.Conclusions:The research institution should establish standardized and feasible processes, the research team should strengthen the management, and the use of the sharing platform is conducive to ensuring the compliance of the medical insurance fund and protecting the interests of the participants.

Impact of global budget on the medical care flow and fund allocation of non-compact medical communities from the perspective of symbiosis / 中华医院管理杂志

Objective:To analyze the impact of global budget on the medical flow treatment and fund allocation in a non-compact medical community based on the symbiosis theory, so as to provide references for relevant authorities to formulate policies for the medical community.Methods:Data on outpatient and emergency visits, discharges, and medical insurance fund usage of the leading hospital and primary medical and health institutions in a non-compact medical community were collected from the health information system of a certain city. The time range of the data spanned from January 2017 to December 2019. The total budget was implemented in April 2018. The symbiotic system of the non-compact medical community was analyzed based on the theory of symbiosis. Descriptive analysis and intermittent time series segmented regression model were used to analyze the changes in indexes related to the flow of medical treatment and fund allocation between the leading hospital and primary institutions under the global budget.Results:The non-compact medical community′s symbiotic system had developed a continuous symbiotic model in organization and an asymmetric reciprocal symbiotic model in behavior. From the perspective of medical treatment flow, the number of outpatient and emergency visits of leading hospital and primary institutions in the medical community showed an upward trend, with little change in the number of discharged patients from 2017 to 2019; The number of patients transferred by the leading hospital increased from 32 in 2017 to 87 in 2019. According to the analysis of the intermittent time series segmented regression model, after the implementation of global budget, the proportion of outpatient and emergency visits in leading hospital was decreased ( β3=-0.43, P<0.05), the proportion of outpatient and emergency visits in primary institutions was on the rise ( β3= 0.02, P<0.05). In terms of fund allocation, the share of health insurance fund of the leading hospital increased from 45.98% in 2017 to 46.51% in 2019, and the primary medical and health institutions decreased from 23.44% to 18.06%, as well as the ratio of per capita income of primary medical and health institutions to that of leading hospitals was decreased from 72.62% to 60.79%. Conclusions:Under the global budget, the outpatient and emergency medical treatment flow in a non-compact medical community had been optimized. However, there was an uneven distribution of funds among medical institutions at all levels. Thus it was recommended to continue to give full play to the positive incentive effect of the global budget, establish a scientific mechanism for distributing benefits, and strengthen supervision and management.

Tangeretin inhibits tumor stemness of non-small cell lung cancer by regulating PI3K/AKT/mTOR signaling pathway / 中国胸心血管外科临床杂志

@#Objective    To study the effect of Tangeretin on non-small cell lung cancer (NSCLC) and the tumor stemness, and to find the molecular mechanism of its effect. Methods    We used cell counting and cell cloning experiments to study the effect of Tangeretin on the proliferation of NSCLC cells in vitro. The effect of Tangeretin on the invasion of NSCLC cells was detected by transwell assay. We detected the effect of Tangeretin on the proliferation of NSCLC cells in vivo by nude mouse tumor-bearing experiment. The effect of Tangeretin on tumor stemness of NSCLC cells was detected by self-renew assay, and CD133 and Nanog protein expressions. The expressions of PI3K/AKT/mTOR signaling pathway-related proteins were detected by Western blotting (WB). Results    Tangeretin had a good inhibitory effect on the proliferation of NSCLC cells in vivo and in vitro. Cell counting experiment, clonal formation experiment and nude mouse tumor-bearing experiment showed that Tangeretin could inhibit the proliferation activity, clonal formation ability, and tumor size of NSCLC cells in vivo. Self-renew experiments showed that Tangeretin could inhibit the self-renew ability of NSCLC cells. WB experiments showed that Tangeretin inhibited the expressions of tumor stemness markers CD133 and Nanog in NSCLC cells. Tangeretin could inhibit the activation of PI3K/AKT/mTOR signaling pathway-related proteins in NSCLC cells, and the activation of PI3K/AKT/mTOR signaling pathway could partially remit the inhibitory  effect of Tangeretin on tumor stemness of NSCLC cells. Conclusion    Tangeretin can inhibit the tumor stemness of NSCLC cells, which may be related to the regulation of PI3K/AKT/mTOR signaling pathway.

Analysis of influencing factors of medical insurance fund settlement in neonatology under DIP payment method / 中国卫生政策研究

Objective:To analyze the DIP medical insurance settlement situation of neonatology and its influencing factors,to optimize the medical insurance settlement rules of neonatology,and to promote the fine management of payment method reform.Methods:City Y,the pilot city of national DIP payment method,was selected as the case area,and the data of the whole sample of patients in neonatology department of City Y were analyzed by descriptive analysis,four-quadrant bubble chart,and multivariate linear regression methods,combined with qualitative data analysis and interview study.Results:There were 1 372 neonates in City Y in 2022,with a health insurance billing rate of 84.82%and 81.10%in tertiary care facilities.There were 718 unenrolled cases.Tertiary care institutions,not enrolled,low-birth-weight babies,higher days of hospitalization,lower days of birth,and lower settlement scores were the influencing factors for the low rate of health insurance settlement in neonatology(P<0.05).Conclusion:Neonatology medical insurance settlement rate was significantly lower than that of the city,and tertiary care institutions had higher deficits,which may lead to the risk of shirking critically ill neonatal patients.There were problems of insufficient grouping refinement and score distortion in neonatology.Recommendation:We should improve the management and adjustment mechanism of core elements,optimize the DIP grouping of neonatology,comprehensively consider the resource consumption characteristics of neonates,rationally and dynamically adjust the price of neonatal medical services,and scientifically set the neonatology markup coefficients,so as to achieve synergistic improvement in the development of neonatology and health insurance,and to push forward the connotative and refined development of the reform of the payment method of health insurance.

The role of the Global Fund to Fight AIDS, Tuberculosis and Malaria in the development of global health and its collaboration with China / 中国血吸虫病防治杂志

The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) has become an increasingly active and influential organization in global health during the past two decades. It is now playing an increasingly important role in the prevention and control of major infectious diseases, international financing for health, public procurement market development across the world. The article outlines the basic architecture of the Global Fund, including its overall information, financing mechanism, operational models and key experiences accumulated. Based on previous cooperation, the article analyzes the importance of the long-term partnership between China and the Global Fund, and proposes policy suggestions to achieve more win-win outcomes in the near future.

Moving toward improved access to medicines and health technologies for cardiovascular disease / Avanzando para mejorar el acceso a los medicamentos y tecnologías sanitarias para las enfermedades cardiovasculares / Avançando para melhorar o acesso a medicamentos e tecnologias de saúde para as doenças cardiovasculares

ABSTRACT The objectives of this article are to describe the interventions carried out by the Strategic Fund of the Pan American Health Organization to facilitate access to and availability of antihypertensive medicines and devices for measuring blood pressure across the Region of the Americas as part of the HEARTS initiative, and to present the preliminary results of price analyses of antihypertensive medicines. The study methodology included a review of reports made by the Strategic Fund between 2019 and 2020, an evaluation of modalities of procurement, a review of the public procurement databases for five antihypertensive medicines, and a comparison with the price obtained by the Strategic Fund. Differences in price ranging from 20% to 99% were identified, indicating significant opportunities for savings. The study also presents interprogrammatic actions that can support the HEARTS initiative, such as the inclusion of antihypertensive medicines recommended by the World Health Organization, consolidation of regional demand and competitively-priced long-term agreements to manage the procurement of quality generic products, and the definition of technical specifications and regulatory requirements to support the procurement of devices to measure blood pressure. This mechanism will enable Member States to reduce their costs significantly, while extending treatment and diagnostic coverage to more people.

RESUMEN Los objetivos del presente artículo son describir las intervenciones realizadas por el Fondo Estratégico de Organización Panamericana de la Salud, para facilitar el acceso y disponibilidad de medicamentos antihipertensivos y dispositivos para la medición de la presión arterial a los países de la Región de las Américas en apoyo a la implementación de la Iniciativa HEARTS; y presentar los resultados preliminares de los análisis de los precios de los medicamentos antihipertensivos. La metodología del estudio incluyó la revisión de informes realizados por el Fondo Estratégico durante los años 2019-2020, la evaluación de las modalidades de adquisición y revisión de las bases de datos de compras públicas para 5 medicamentos antihipertensivos, y el análisis comparativo con el precio obtenido por el Fondo Estratégico. Se identificaron diferencias que oscilaron entre 20% y 99%, lo que evidencia oportunidades de ahorro significativas. Asimismo, se presentan las acciones interprogramáticas desarrolladas en apoyo a la Iniciativa HEARTS, entre las que se destacan la inclusión de medicamentos antihipertensivos recomendados por la Organización Mundial de la Salud; la consolidación de la demanda regional y el establecimiento de precios competitivos con acuerdos a largo plazo para gestionar la adquisición de productos genéricos de calidad; y la definición de especificaciones técnicas y requisitos regulatorios para apoyar con la adquisición de dispositivos para la medición de la presión arterial. A través de este mecanismo, los Estados Miembros pueden disminuir sus costos significativamente, extendiendo cobertura del tratamiento y diagnóstico a más personas.

RESUMO Os objetivos deste artigo são descrever as intervenções realizadas pelo Fundo Estratégico da Organização Pan-Americana da Saúde para facilitar o acesso e a disponibilidade de medicamentos anti-hipertensivos e aparelhos de medição de pressão arterial aos países da Região das Américas, em apoio à implementação da iniciativa HEARTS; e apresentar os resultados preliminares da análise dos preços dos medicamentos anti-hipertensivos. A metodologia do estudo incluiu a revisão de relatórios feitos pelo Fundo Estratégico durante os anos de 2019 e 2020, a avaliação das modalidades de aquisição e revisão dos dados de compras públicas de 5 medicamentos anti-hipertensivos e uma análise comparativa com o preço obtido pelo Fundo Estratégico. Foram identificadas diferenças que oscilaram entre 20% e 99%, o que evidencia oportunidades de economia significativas. Da mesma forma, são apresentadas as ações interprogramáticas desenvolvidas em apoio à iniciativa HEARTS, entre as quais se destacam a inclusão de medicamentos anti-hipertensivos recomendados pela Organização Mundial da Saúde; a consolidação da demanda regional e o estabelecimento de preços competitivos com acordos de longo prazo para gerenciar a aquisição de genéricos de qualidade; e a definição de especificações técnicas e requisitos regulatórios para subsidiar a aquisição de aparelhos de medição de pressão arterial. Por meio desse mecanismo, os Estados Membros podem reduzir seus custos significativamente, ampliando a cobertura de tratamento e diagnóstico para atingir mais pessoas.

O Fundo de Saúde e sua apropriação pelas Organizações Sociais no município de São Paulo / The Health Fund and its appropriation by Social Organizations in the municipality of São Paulo

RESUMO Discute-se o Fundo de Saúde do município de São Paulo, destacando a apropriação dos seus recursos pelo setor privado, especialmente pelas Organizações Sociais (OS). Para tanto, a primeira parte apresenta os fundamentos mais gerais do Fundo Público. A segunda parte analisa a trajetória histórica do Fundo Municipal de Saúde e a utilização de seus recursos, em grande medida, para o financiamento da atenção básica, via Programa de Saúde da Família, executado pelas OS. A terceira apresenta as características das OS, analisando a evolução da apropriação dos recursos do Fundo de Saúde entre 2011 e 2021. Percebe-se que os recursos do Fundo de Saúde passam a ser cada vez mais apropriados por essas entidades de caráter privado, apresentando uma tendência de crescimento, alcançando um patamar de 89,2% do total dos recursos em 2021. Desse modo, constata-se o movimento de mercantilização implícita, marcado pela lógica de ampliação dos mecanismos de mercado no Sistema Único de Saúde municipal.

ABSTRACT The Health Fund of the municipality of São Paulo has been discussed, highlighting the appropriation of its resources by the private sector, especially by Social Organizations (OS). To this end, the first part presents the more general foundations of the Public Fund. The second part analyzes the historical trajectory of the Municipal Health Fund and the use of its resources, to a large extent, to finance primary care, via the Family Health Program executed by the OS. The third part presents the characteristics of the OS, analyzing the evolution of the appropriation of resources of the Health Fund between 2011 and 2021. It can be seen that the Health Fund resources are increasingly appropriated by these private entities, with a growing trend, reaching a level of 89.2% of total resources in 2021. Thus, the movement of implicit mercantilization is verified, marked by the logic of expansion of market mechanisms in the municipal Unified Health System.

Financiamento do esporte no distrito federal: fontes, magnitude e direcionamento dos gastos de 2009 a 2019 / Sports funding in the federal district: sources, magnitude and directions of expenditure from 2009 to 2019 / Financiamiento del deporte en el distrito federal: fuentes, magnitud y destino del gasto de 2009 a 2019

Resumo O financiamento público vem ganhando destaque nos estudos das políticas públicas esportivas, pois permite visualizar de forma mais transparente onde e como são alocados os recursos públicos para o setor. Este artigo tem como objetivo analisar o financiamento das políticas públicas de esporte do Distrito Federal (DF), a partir de matriz e proposta metodológica que possibilitam o levantamento e sistematização de dados referentes à identificação das fontes, magnitude e direcionamento dos gastos públicos orçamentários com o esporte de 2009 a 2019. A pesquisa apontou: (i) falta de legislação efetiva para garantia dos recursos esportivos; (ii) centralidade da execução do orçamento pela Secretaria de Esporte do Distrito Federal; (iii) elevado gasto com a construção do Estádio Nacional de Brasília; e, (iv) hierarquização dos gastos esportivos nos programas oferecidos, com priorização aos Centros Olímpicos e Paralímpicos, ação com gestão terceirizada, além de capilaridade e abrangência reduzidas.

Abstract Public funding has been gaining prominence in studies of sports public policies as it provides a more transparent view of where and how public resources are allocated to the sector. This article aims to analyze the financing of public policies for sports in the Federal District (FD), based on a matrix and methodological proposal that allows the survey and systematization of data referring to the identification of sources, magnitude, and direction of public budget expenditure on sports from 2009 to 2019. The research points out: (i) the lack of effective legislation to guarantee sports resources; (ii) the centrality of budget execution by the Secretariat of Sports of the Federal District; (iii) high expenses with the construction of the Brasília National Stadium; and (iv) the prioritization of sports spending in the offered programs, with priority given to the Olympic and Paralympic Centers, outsourced management, in addition to reduced capillarity and scope.

Resumen La financiación pública ha ido cobrando protagonismo en los estudios de políticas públicas deportivas, ya que permite tener una visión más transparente de dónde y cómo se asignan los recursos públicos al sector. Este artículo tiene como objetivo analizar del financiamiento de las políticas públicas deportivas en el Distrito Federal (DF), a partir de una propuesta matricial y metodológica que permite recolectar y sistematizar datos referentes a la identificación de fuentes, magnitud y dirección del gasto público presupuestario en deportes, de 2009 a 2019. La investigación señaló: (i) la falta de una legislación efectiva para garantizar los recursos deportivos; (ii) la centralidad de la ejecución presupuestaria por parte de la Secretaría de Deportes del Distrito Federal; (iii) altos gastos con la construcción del Estadio Nacional de Brasilia; y (iv) la priorización del gasto deportivo en los programas ofrecidos, con prioridad en los Centros Olímpicos y Paralímpicos, gestión externalizada, además de capilaridad y alcance reducidos.

Transferências fundo a fundo: coordenação e cooperação federativa na segurança pública do Brasil / Transferencias fondo a fondo: coordinación y cooperación federativa en seguridad pública en Brasil / Fund-to-fund transfers: federative coordination and cooperation in public security in Brazil

Resumo O objetivo deste artigo é analisar a realização de transferências fundo a fundo e avaliar se ela tem contribuído para a coordenação e cooperação federativa de políticas voltadas à segurança pública no Brasil. Para tanto, o trabalho foi dividido em três etapas: (i) levantamento dos valores do Fundo Nacional de Segurança Pública (FNSP), destinados aos estados e ao Distrito Federal, no período de 2000 a 2022, antes e depois da adoção das transferências fundo a fundo; (ii) realização de entrevistas semiestruturadas para levantar as percepções dos gestores responsáveis pela elaboração e coordenação do processo de descentralização e pelo acompanhamento da execução dos recursos descentralizados; e (iii) análise dos mecanismos de coordenação/cooperação previstos nos planos de aplicação elaborados pelos estados no período supracitado. Os achados da pesquisa confirmam resultados de estudos anteriores sobre o poder de indução das transferências fundo a fundo na cooperação e coordenação de políticas nacionais, também para a área de segurança pública. Verificou-se que a ampliação de recursos e a obrigatoriedade de seu compartilhamento com os estados favoreceram o alinhamento das políticas estaduais às diretrizes estabelecidas pela União, mas que ainda é incipiente a interação entre os órgãos, organizações e membros da sociedade em relação ao tema.

Resumen El objetivo de este artículo es analizar si las transferencias de fondo a fondo han contribuido a la coordinación y cooperación federal de las políticas dirigidas a la seguridad pública en Brasil. Para ello, el trabajo se dividió en tres etapas: (i) Relevamiento de los montos del Fondo Nacional de Seguridad Pública asignados a los estados y al Distrito Federal en el período 2000-2022, antes y después de la adopción de las transferencias fondo a fondo; (ii) Realización de entrevistas semiestructuradas para conocer la percepción de los gerentes responsables de preparar y coordinar el proceso de descentralización y monitorear la ejecución de los recursos descentralizados; y (iii) Análisis de los mecanismos de coordinación/cooperación previstos en los planes de aplicación elaborados por los estados en el período. Los hallazgos de la investigación confirman los resultados de estudios previos sobre el poder de inducción de las transferencias fondo a fondo en la cooperación y coordinación de políticas nacionales también para el área de seguridad pública. Se verificó que la ampliación de los recursos y la obligatoriedad de compartirlos con los estados favorecieron el alineamiento de las políticas estatales con las directrices establecidas por el Gobierno federal, pero que la interacción entre organismos, organizaciones y miembros de la sociedad sobre el tema es aún incipiente.

Abstract This article aims to analyze whether fund-to-fund transfers have contributed to federal coordination and cooperation of policies aimed at public security in Brazil. To this end, the work was divided into three stages: (i) Survey of National Public Security Fund amounts allocated to the states and the Federal District in the period from 2000 to 2022, before and after the adoption of fund-to-fund transfers; (ii) Conducting semi-structured interviews to raise the perceptions of managers responsible for preparing and coordinating the decentralization process and monitoring the execution of decentralized resources; and (iii) Analysis of the Coordination/Cooperation mechanisms foreseen in the Application Plans prepared by the states in the period. The research findings confirm the results of previous studies on the induction power of fund-to-fund transfers in the cooperation and coordination of national policies for public security. It was verified that the expansion of resources and the obligatoriness of their sharing with the states favored the alignment of state policies with the guidelines established by the Union but that the interaction between bodies, organizations, and members of society on the subject is still incipient.

Dependência, ciclo do capital e limites do fundo público no Brasil / Dependency, capital cycle and limits of the public fund in Brazil

Resumo: Este artigo visa identificar a participação e os limites do fundo público no ciclo do capital da economia dependente brasileira. Para isso, aborda as implicações do intercâmbio desigual, da transferência de valor e da superexploração da força de trabalho para a composição e direcionamento do fundo público no Brasil, utilizando-se da coleta e análise de dados acerca do sistema tributário brasileiro.

Abstract: This article aims to identify the participation and limits of the public fund in the capital cycle of the Brazilian dependent economy. To this end, it addresses the implications of unequal exchange, value transfer and overexploitation of the labor force for the composition and direction of public fund in Brazil, using the analysis of data about the Brazilian tax system.

Capitalismo dependente e as políticas sociais brasileiras: política de assistência social em questão / Dependent capitalism and Brazilian social policies: social assistance policy under discussion

Resumo: Este artigo apresenta o debate acerca da política de Assistência Social na contemporaneidade do ponto de vista do padrão das políticas sociais brasileiras, delineado a partir da Teoria Marxista da Dependência. Sinaliza seu caráter estruturalmente restrito e localiza seu ciclo breve de construção, gradualmente inviabilizado após 2016.

Abstract: This article presents the debate about the Social Assistance Policy in contemporary times from the perspective of the pattern of Brazilian social policies, delineated from the Marxist Theory of Dependence. It points out its structurally restricted nature and locates its brief construction cycle, which gradually became unfeasible after 2016.

The increase of philanthropic entities in the SUS: what does this scenario reveal? / O aumento de entidades filantrópicas no SUS: o que esse cenário revela?

ABSTRACT The article analyzes aspects of the change in the legal nature of private healthcare from "for-profit" to "non-profit" entities. It is an exploratory research, supported by the policy analysis framework, focusing on secondary data from the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities - CNES) from 2012 to 2020 and a case study. The results show an increase in these entities in all regions of the country and evidence that they behave like profit-oriented entities. The change in legal nature hides a broader process of implicit commodification of healthcare services, encouraged by state policies and related to exemptions provided by law.

RESUMO O artigo analisa aspectos da mudança da natureza jurídica de instituições privadas de assistência à saúde, de estabelecimentos "com" para "sem" fins lucrativos. Trata-se de uma pesquisa exploratória, apoiada no referencial de análise de políticas, com foco em dados secundários, provenientes do Sistema de Cadastro Nacional de Estabelecimentos de Saúde (SCNES), de 2012 a 2020, e estudo de caso. Os resultados apresentam aumento dessas entidades em todas as regiões do país e evidências de que se comportam como estabelecimentos com fins lucrativos. A mudança de natureza jurídica oculta um processo mais amplo de mercantilização implícita dos serviços de saúde, incentivado por políticas estatais e relacionado às isenções previstas em lei.

A STUDY OF MUTUAL FUND ACCOUNTING IN PERSPECTIVE OF BUILDING NATION

Mutual Fund is a fund establishment in the form of a trust to raise money through the sale of units to the public or a section of the public under one or more schemes for investing in securities, including money market instrument. The investors want to know about the present and past performance of the selected mutual funds. This information must be supported by certi?ed documents. The system of accounting for Mutual Fund is different from conventional system of accounting which is followed in industrial sectors. Hence, only proper accounting for mutual funds can show the real picture of risk and return of a speci?c mutual fund. An investor may compare accounting information relating to a mutual fund with its benchmark return. He can do the comparison with con?dence on the basis of audited report of a particular fund. Moreover proper system of mutual fund accounting leads the fund manager to minimize cost