Name: EDUARDO HENRIQUE LORETI
Publication date: 25/10/2017
Advisor:
Name |
Role |
|---|---|
| ALVIM BORGES DA SILVA FILHO | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| ALVIM BORGES DA SILVA FILHO | Advisor * |
Summary: The contractual arrangements were introduced in the Brazilian health sector aiming 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 not yet conclusive. It is known, however, that contractual arrangements are not the solution to all health sector problems. In this way more 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. For this, the three state hospitals contracted in the ES were chosen. An analysis of the contracts in force and the collection of established contractual goals was carried out and a comparison was made with the hospital production presented by the hospitals and collected through Tabwin. In the second moment, a semi-structured interview was conducted with two managers of the Health Department and three OSS leaders and later discourse analysis in order to understand the contract process. 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 model.
