Mediante revisão narrativa, realizou-se atualização da concepção teórico-metodológica Paideia construída por Campos, bem como foram apontadas instituições públicas que adotaram essa estratégia nas duas últimas décadas. Analisou-se sua aplicação e desdobramentos metodológicos no espaço da gestão (apoio institucional), nas relações interprofissionais (apoio matricial) e na prática da clínica.
An historical analysis of Brazil's policies in Primary Healthcare
Este estudo objetivou compreender a formulação do apoio institucional pelo Ministério da Saúde (MS) e como essa estratégia do método da roda vem sendo incorporada ao discurso oficial da gestão federal do SUS. O estudo se situa na categoria de pesquisa qualitativa. Analisamos documentos oficiais, diretrizes nacionais, cadernos de formação e políticas do MS. Identificamos dilemas, dificuldades e limites que os gestores do SUS vivenciam, cotidianamente, ao buscarem estratégias de mudança da lógica tradicional de governo (racionalidade gerencial hegemônica), seja na gestão democrática e participativa, ou na relação entre entes federados. A partir dos documentos analisados, pode-se supor um desejo de mudança por parte desses gestores, visto a consistência teórico-política adequada a isso. Entretanto, apresentam contradições, mostrando dificuldade de integração entre as áreas do MS e deste com os gestores descentralizados (estados e municípios). This study aimed to understand how institutional support was formulated by the Ministry of Health and how this strategy of a round-table method has been incorporated into the official discourse of the federal management of SUS. This study is categorized as qualitative research. We analyzed official documents, national guidelines, training booklets and policies of the Ministry of Health. We identified dilemmas, difficulties and limits that SUS managers experience daily while seeking strategies to change the traditional logic of government (hegemonic managerial rationality), either through democratic and participative management or in the relationship between federal entities. From the documents analyzed, it may be supposed that these managers have a desire for change, given that the politicaltheoretical consistency is appropriate for this. However, the documents present contradictions and show the difficulty of integration between areas of the Ministry of Health and between this ministry and the decentralized managers (states and municipalities).
This study aims to analyze the implementation of Hospital Policies in Brazilian Federal University Hospitals (HUFs), seeking to describe the planning, structure, work management and financing of these hospitals. The aim is to understand the managers' perception about the implementation of the National Hospital Attention Policy (PNHOSP) guidelines in their institutions and to analyze the effects of the management reforms produced by the Brazilian Hospital Services Company (EBSERH) at Federal University Hospitals. The study is part of the public policies analysis field, using strategies and procedures of mixed methods of research, with quantitative and qualitative approaches. The quantitative approach is composed by the descriptive study of secondary data from the Brazilian Unified Health System (SUS) and the EBSERH and by the descriptive analysis of a Likert scale structured questionnaire applied to HUF managers. The qualitative approach deals with documentary analysis, through thematic content analysis, of the Strategic Executive Plans (PDEs) of the 50 HUFs. As opposed to the general picture of Brazilian hospitals, the federal university hospital facilities are close to international trends because they lodge hospitals with a higher average number of beds, higher concentration of technological density, as well as being constituted in research centers, health professionals training fields and in being reference to the medium and high complexity attention levels. Specific administrative and managerial reforms for federal university hospitals, including the Federal University Hospitals Restructuring Program (REHUF) and EBSERH, have brought concrete possibilities to overcome the historical challenges of hospitals in the SUS. Even so, there is still controversy about the managerial alternative with an indirect management character adopted by the federal government. Positive impacts were identified in the reduction of chronic underfunding, with a real increase in public resources, originating from the SUS and Ministry of Education (MEC), which resulted in an increase in the number of beds and in high complexity diagnostic and therapeutic support equipment. The implementation of EBSERH, replacing private foundations, has made it possible to reduce the precariousness of labor relations and to professionalize the management of HUFs. The implemented policies reduced regional inequalities in access to the federal network of university hospitals. Workforce management policies have advanced in the expansion of the number of employees to HUFs, replacing foundational employees with EBSERH employees through public tenders and career plans. In general, it was possible to verify the difficulty of making changes in the federal university hospital network that benefit users and that manage to ensure greater visibility to the current power structure in these institutions. This is evident from the centralized way in which planning is done and how decisions are made, excluding users, professionals and, especially, other instances of SU...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.