Possibilidades e limites do processo de contratualização de organizações sociais de saúde nos hospitais públicos estaduais no Estado do Espírito Santo
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Data
2017-10-25
Autores
Loreti, Eduardo Henrique
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Universidade Federal do Espírito Santo
Resumo
The contractual arrangements were introduced in the Brazilian health sector in order to improve the organization of the health system with the objective that this would reflect in the improvement of hospital performance. The first experiences of contractual arrangements in Brazil occurred in 1991, and since then have been developed and implemented. However, the understanding of the effective impact of contractual arrangements on hospital performance and contractual risks is still inconclusive. It is known, however, that contractual arrangements are not the solution to all problems of the health sector, therefore, further studies are needed in the area. In this sense, the main objective of this work was to describe and analyze the process of contracting services in State Public Hospitals administered by Social Organizations in the State of Espírito Santo. Therefore, three state hospitals contracted in Espírito Santo were chosen for this study. At first, an analysis of the contracts in force and the collection of established contractual goals were carried out and, later, a comparison with the hospital production presented by the hospitals and collected through Tabwin. In the second moment, we conducted semi-structured interviews with two managers of the Health Secretariat and three leaders of the Social Health Organizations (OSS) and later analysis of the speech with the objective of understanding the process of contracting. Contractualisation seems to have improved the amount of services provided by hospitals. However, the process has been presenting some limits, such as: poorly designed contracts; lack of qualification of those involved; opportunistic behavior; technical staff; budget and goals that do not fit the reality of the State. Thus, the process of contracting OSS in ES has not been shown to be a good management model.
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Contractualisation , Health Organizations , Public Administration , Contratualização , Gestão Pública , Organizações Sociais de Saúde