* Valores obtidos por soma. Há dupla contagem, tendo em vista que o pesquisador que participa de dois ou mais grupos classificados em grandes áreas predominantes diferentes foi computado uma vez em cada grande área.
ObjectiveTo characterize the Brazilian philanthropic hospital network and its relation to the public and private sectors of the Sistema Unico de Saude (SUS) [Brazilian Unified Health System]. Methods This is a descriptive study that took into consideration the geographic distribution, number of beds, available biomedical equipment, health care complexity as well as the productive and consumer profiles of philanthropic hospitals. It is based on a sample of 175 hospitals, within a universe of 1,917, involving 102 distinct institutions. Among these, there were 66 Brazilian Unified Health System (SUS) inpatient care providers with less than 599 beds randomly included in this study. Twenty-six of the twenty-seven SUS inpatient care providers with at least 599 beds, as well as ten institutions which do not provide their services to SUS, were also included. This is a cross-sectional study and the data was obtained in 2001. Data collection was conducted by trained researchers, who applied a questionnaire in interviews with the hospital's managers.
ResultsWithin the random sample, 81.2% of the hospitals are located in cities outside of metropolitan areas, and 53.6% of these are the only hospitals within their municipalities. Basic clinical hospitals, without ICUs, predominate within the random sample (44.9%). Among the individual hospitals of the large philanthropic institutions and the special hospitals, the majority -53% and 60% respectively -are level II general hospitals, a category of greater complexity. It was verified that complexity of care was associated to hospital size, being that hospitals with the greatest complexity are situated predominantly in the capitals. Conclusions Given the importance of the philanthropic hospital sector within the SUS in Brazil, this paper identifies some ways of formulating appropriate health policies adjusted to the specificities of its different segments.
OBJECTIVE:To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil.
METHODS:The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group from the philanthropic hospital sector, in six dimensions: management and planning, economics and finance, human resources, technical services, logistics services and information technology. Data from a random sample of 69 hospitals within the philanthropic hospital sector and 94 philanthropic hospitals that operate their own health plans were evaluated. In both cases, only the hospitals with less than 599 beds were included.
RESULTS:The results identified for the hospitals that operate their own health plans were more positive in all the managerial dimensions compared. In particular, the economics and finance and information technology dimensions were highlighted, for which more than 50% of the hospitals that operated their own health plans presented almost all the conditions considered.
CONCLUSIONS:The philanthropic hospital sector is important in providing services to the Brazilian Health System (SUS). The challenges in maintaining and developing these hospitals impose the need to find alternatives. Stimulation of a public-private partnership in this segment, by means of operating provider-owned health plans or providing services to other health plans that work together with SUS, is a field that deserves more in-depth analysis.
The paper seeks to provide an analysis on the main factors which determine the dynamics of production and innovation in the scope of HEIC. In doing so, it seeks to examine the relation between the health production system and the health innovation system in Brazil.Therefore, health sector is seen as an interdependent economic space that characterizes both an innovation system and a production system, which conjoin enormous potential for knowledge generation, mass consumption and marked presence of the State in the regulation and promotion of activities and innovation.
Artigo disponível em português e inglês em: www.scielo.br/rsp
O papel dos hospitais na dinâmica de inovação em saúdeThe role of hospitals in the dynamic of health care innovation RESUMO O artigo analisa o papel dos serviços hospitalares na dinâmica de inovação em saúde, considerando-os como força motriz do processo de inovação no Complexo Econômico-Industrial da Saúde. Além disso, enfatiza-se a potencialidade desses serviços em articular virtuosamente as dimensões socioeconômicas do desenvolvimento. Utilizando-se do arcabouço da economia política da saúde, propõem-se aportes para o desenvolvimento de uma base analítica e de novos modelos de análise estratégica das condições institucionais, tecnológicas e de gestão hospitalar, bem como de suas interrelações no complexo produtivo da saúde. O artigo objetiva, dessa forma, aprofundar a compreensão sobre a dinâmica de inovação a partir dessas organizações.
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ABSTRACTThe article analyzes the role played by hospital services in the dynamic of health care innovation, considering that these are the driving force of the innovation process within the Economic-Industrial Health Care Complex. In addition, the services' potential for articulating virtuously the economic and social dimensions of development is emphasized in the article. By using the framework of the political economy of health, contributions are proposed to the development of an analytical basis and of new models for strategic analysis of institutional, technological and hospital management conditions, as well as of their interconnections within the health care productive complex. Thus, the article aims to deepen the understanding about innovation dynamics as seen from these organizations.
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