Scarcity and abundance: Medical imaging equipment supply in Brazil

Introduction - Countries with a colonial history and development of a capitalism associated with the international capital, in general, have dual economies. Intense social inequalities are a distinct feature also. In health, this is reflected in an overlapping pattern of health - chronic-degenerative versus infectious diseases and external causes - and also in the vast inequality of supply, access and use of health care.
In the case of high complexity health care, this is aggravated by the frequent dependence on imports of a few manufacturers generating high costs for the country.
Objectives - The paper analyzes the dynamics of medical imaging equipment delivery in Brazil between 1999 and 2005, identifying distinct public and private patterns and geographical inequalities.

Methodology - An exploratory study was based on quantitative data from selected medical imaging equipment from census surveys of Health Care Providers of the Brazilian Institute of Geography and Statistics in their latest versions (1999, 2002 and 2005) and the Outpatient Information System of the National Health System / SUS.
Results - Growth of 20% over the period, more pronounced in high-cost equipment and an enlarged participation of the public sector. Reduction of supply of private equipments to SUS, more pronounced in high-cost ones. The rate of supply is extremely uneven: with the exception of equipments of mammography, public supply is less than the parameters of the Ministry of Health The private supply of equipment for computed tomography and nuclear magnetic resonance exceeds the average rate in the United States in 2004. There was relative reduction of geographical inequality, due mainly to the public sector.
Discussion – the work points out the need to review the policy of acquisition of biomedical equipment and state contracting-out to reduce disparities between universal and private supply.