DETERMINANTES DAS RECEITAS PRÓPRIAS EM UNIDADES SUBNACIONAIS: o caso dos municípios maranhenses

O presente estudo tem por objetivo analisar o status da gestão das receitas próprias nos municípios maranhenses, identificando alguns elementos explicativos que possam ser associados a uma boa gestão fiscal no âmbito municipal. Recorrendo ao uso da análise de regressão, o estudo confronta o Índice Firjan de Gestão Fiscal (IFGF) com cinco variáveis sugeridas como fatores determinantes do referido índice, no caso, o nível de renda per capita, o número de empresas per capita, a participação dos serviços prestados pelo setor privado na economia do município, a parcela da população urbana em relação à população total e a participação do setor público na economia local. Utilizando médias de indicadores representativos do período 2010-2014, um período de relativa normalidade em termos de crescimento econômico nos níveis nacional e regional, a conclusão aponta a importância da capacidade empreendedora dos munícipes (empresas per capita), a pujança do setor de serviços (participação dos serviços na economia municipal) e a participação do setor público na economia como causas importantes da boa gestão fiscal no âmbito das prefeituras do Maranhão. O estudo sugere, então, que as políticas públicas direcionadas à melhoria da administração das receitas municipais devem considerar tais elementos causativos como foco estratégico, de modo que as metas administrativas possam ser alcançadas com eficiência.Palavras-chave: Administração pública. Finanças públicas. Receitas próprias. Gestão fiscal. Maranhão. Municípios.DETERMINANTS OF OWN REVENUE IN SUBNATIONAL UNITS: the case of maranhão municipalitiesAbstractThis study aims to analyze the status of the management of own revenues in the municipalities of Maranhão, identifying some explanatory elements that can be associated with good fiscal management at the municipal level. Using the regression analysis, the study compares the Firjan Tax Management Index (IFGF) with five variables suggested as determining factors of the referred index, in this case, the level of income per capita, the number of companies per capita, the participation of the services provided by the private sector in the municipality's economy, the share of the urban population in relation to the totalpopulation and the participation of the public sector in the local economy. Using averages of representative indicators for the period 2010-2014, a period of relative normality in terms of economic growth at national and regional levels, the conclusion points to the importance of the entrepreneurial capacity of citizens (companies per capita), the strength of the service sector (participation of services in the municipal economy) and the participation of the public sector in the economy as important causes of good fiscal management in the scope of the municipalities of Maranhão. It is suggested, then, that public policies aimed at improving the administration of municipal revenues should consider such causative elements as a strategic focus, so that administrative goals can be achieved efficiently.Keywords: Public administration. Public finance. Own revenue. Tax management. Maranhão. Counties

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Comparison of international normalized ratio audit parameters in patients enrolled in GARFIELD-AF and treated with vitamin K antagonists

Vitamin K antagonist (VKA) therapy for stroke prevention in atrial fibrillation (AF) requires monitoring of the international normalized ratio (INR). We evaluated the agreement between two INR audit parameters, frequency in range (FIR) and proportion of time in the therapeutic range (TTR), using data from a global population of patients with newly diagnosed non-valvular AF, the Global Anticoagulant Registry in the FIELD\u2013Atrial Fibrillation (GARFIELD-AF). Among 17\ua0168 patients with 1-year follow-up data available at the time of the analysis, 8445 received VKA therapy (\ub1antiplatelet therapy) at enrolment, and of these patients, 5066 with 653 INR readings and for whom both FIR and TTR could be calculated were included in the analysis. In total, 70\ua0905 INRs were analysed. At the patient level, TTR showed higher values than FIR (mean, 56\ub70% vs 49\ub78%; median, 59\ub77% vs 50\ub70%). Although patient-level FIR and TTR values were highly correlated (Pearson correlation coefficient [95% confidence interval; CI], 0\ub7860 [0\ub7852\u20130\ub7867]), estimates from individuals showed widespread disagreement and variability (Lin's concordance coefficient [95% CI], 0\ub7829 [0\ub7821\u20130\ub7837]). The difference between FIR and TTR explained 17\ub74% of the total variability of measurements. These results suggest that FIR and TTR are not equivalent and cannot be used interchangeably