Executive evaluation of the national cost management program of the ministry of health, Brazil
1
Federal University of Bahia, Salvador, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A3626
ABSTRACT
INTRODUCTION:
The National Cost Management Program (PNGC) was established within the Ministry of Health (MS) in 2018 with the objective of promoting the systematic assessment and management of costs in healthcare facilities of the Unified Health System (SUS). The historical absence of consolidated cost information represents an obstacle to managerial decision-making, public spending efficiency, and management transparency. In this context, an Executive Evaluation of the PNGC was conducted to analyze its design, implementation, results, and opportunities for improvement.
METHODS:
The evaluation was guided by key questions addressing problem diagnosis, policy design, governance, implementation, results, impacts, and economic analysis. Quantitative and qualitative approaches were used, including document analysis, examination of administrative data from the APURASUS system covering the period from 2013 to December 2024, as well as semi-structured interviews with managers and technical staff from the Ministry of Health and state and municipal secretariats.
RESULTS:
The results indicate significant progress in the consolidation of the PNGC, with a substantial increase in the number of units registered in APURASUS, surpassing one thousand records over the period analyzed. A greater concentration of units was observed in the Southeast and Northeast regions, especially in Minas Gerais. Training initiatives and technical support from the Ministry of Health were identified as key factors influencing adherence to the program. However, challenges persist, particularly related to turnover among managers, regional inequalities, limitations in human resources, and governance weaknesses—especially regarding social oversight.
CONCLUSIONS:
It is concluded that the PNGC represents a relevant advancement for strengthening cost management in the SUS, but it still requires institutional, regulatory, and operational improvements. Strengthening governance, expanding regional technical support, and improving financial monitoring mechanisms are recommended to ensure the program’s sustainability and national expansion.
The National Cost Management Program (PNGC) was established within the Ministry of Health (MS) in 2018 with the objective of promoting the systematic assessment and management of costs in healthcare facilities of the Unified Health System (SUS). The historical absence of consolidated cost information represents an obstacle to managerial decision-making, public spending efficiency, and management transparency. In this context, an Executive Evaluation of the PNGC was conducted to analyze its design, implementation, results, and opportunities for improvement.
METHODS:
The evaluation was guided by key questions addressing problem diagnosis, policy design, governance, implementation, results, impacts, and economic analysis. Quantitative and qualitative approaches were used, including document analysis, examination of administrative data from the APURASUS system covering the period from 2013 to December 2024, as well as semi-structured interviews with managers and technical staff from the Ministry of Health and state and municipal secretariats.
RESULTS:
The results indicate significant progress in the consolidation of the PNGC, with a substantial increase in the number of units registered in APURASUS, surpassing one thousand records over the period analyzed. A greater concentration of units was observed in the Southeast and Northeast regions, especially in Minas Gerais. Training initiatives and technical support from the Ministry of Health were identified as key factors influencing adherence to the program. However, challenges persist, particularly related to turnover among managers, regional inequalities, limitations in human resources, and governance weaknesses—especially regarding social oversight.
CONCLUSIONS:
It is concluded that the PNGC represents a relevant advancement for strengthening cost management in the SUS, but it still requires institutional, regulatory, and operational improvements. Strengthening governance, expanding regional technical support, and improving financial monitoring mechanisms are recommended to ensure the program’s sustainability and national expansion.
| eISSN: | 2654-1459 |
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