Hospitais públicos sob gestão de organizações sociais de saúde na grande Vitória : um estudo comparativo

• Autor(a) principal: Turino, Fabiana
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/5571
• topic: Social organizations; Public politics; Public funding; Public administration; Organização social; Gestão pública; Financiamento público; Saúde Coletiva; Administração pública; Políticas públicas; Saúde coletiva; Estrutura social; 614

This work investigates the amount of financial resources allocated to the six public general hospitals of Grande Vitoria in order to understand the entry of Social Organizations of Health (OSSs) in the management of public hospitals. Initially we approach the process of administrative reform of the state, guided by the Master Plan of the State Apparatus Reform, which created the legal basis allowing the emergence of social organizations as management tools. As management alternatives of public health services, the proposed reform of the State, mark the downsizing of the state apparatus and the transfer of non-exclusive management services, such as health, education and culture, to private entities. The question posed by this work, therefore, is mainly aimed to compare the financial resources intended to the three public hospitals managed by OSS in Grande Vitória with three units administered by the Espírito Santo's State Office of Health (SESA). In order to achieve this goal, a qualitative and quantitative research was held from analysis of documents that were available from government transparency devices such as management reports of SESA, Budget Laws, information from the National Health System (SUS), the Cadastre Health establishments (CNES) among others. From these data it was possible to understand how the debate about the birth of OSS in Brazil and the Espírito Santo State is now reflected in the distribution of public resources for health. The six general hospitals analyzed demonstrate the divergence of allocation of financial support. In the third chapter of this work we present the data, in a comparative way, of the financial resources allocated to the six hospitals investigated. We also studied the proposed funding through Parliamentary Amendments, by Espirito Santo State Representatives, for charities with title of Social Health Organization who administer public general hospitals of Grande Vitória. We ended this dissertation with considerations that allow us to state that the adoption of a new public management through OSS does not mean automatic increase in the quality level of access to public health services. On the contrary, it proved to be an expansion of public spendings directed to the OSSs at the expenses of hospitals managed directly by the state. An example of this is the fact that almost 12% of the health budget of all the Espírito Santo State was sent to three hospitals managed by OSSs in 2014, while the three administered directly by the state received 4.6%. Another example is the average cost of the services rendered. While the three hospitals under state management held 3,005,072 visits between 2009 and 2014, the units administered by OSSs made 2,235,559 attendances. The average cost of each service was: R $ 84.03 and R $ 232 02, respectively, from state transfers of R $ 252.5 (State) and R $ 518.7 million (OSS).