Os desafios da avaliação na gestão do SUS

Abstract

Revista Ciência & Saúde Coletiva has dedicated publications to the theme of evaluation assessing mainly methodological approaches and alternative designs for evaluative research.This edition seeks to contribute to the dissemination of research work carried out in order to foster debate on the problems faced by the SUS in the development of health management and thus provide more objective decision-making and effective alternatives in pursuing the principles of universality, comprehensiveness and equity.The papers presented cover topics such as: the potential provided by the use of evaluation for decision-making with greater effectiveness; methodologies for creating a monitoring panel applicable to the management of the SUS; basic guidelines necessary for the evaluation of performance; analysis of the scope and limits of decentralized management; budgetary/financial evaluation methodologies; the identification of key steps for the planning and monitoring of municipal management and the conditions necessary for the evaluation of policy, and the creation of strategic agendas.In addition to disseminating theoretical and experimental approaches attempted in the field of evaluation of health, this edition also reflects part of the effort made by members of the Abrasco Evaluation WG in order to foster the performance of evaluations at all levels of management. This work had the important and significant contribution of the Department for Strategic and Participative Management of the Ministry of Health in 2010, via the Department of Monitoring and Evaluation of Management of the SUS.We are aware that despite our best efforts it was not possible to cover all the important aspects of management that would benefit from evaluation work. However, a careful reading of the articles will enable managers and researchers to identify important contributions that evaluation can offer to improve the management of services, systems and programs in the SUS.

Análise da Oferta e da Demanda por Serviços de Saúde de um Território Sanitário como Contribuição para a Atenção e Gestão em Saúde

“…Estudos apontam que a complexidade para a operacionalização dos sistemas de saúde é um desafio para os gestores (Pires et al, 2010;Tanaka et al, 2012).…”

“…Essa assimetria entre oferta e demanda é um dos fatores contributivos para a complexidade da gestão do Sistema Único de Saúde (SUS), a qual foi percebida desde o momento de sua concepção (Tanaka et al, 2012;Duncan et al, 2015).…”

Performance Evaluation of the Brazilian Health System in 215 Discourses: Comparative Simplifications and Control Weaknesses

“…An obstacle to a broader use of evaluation in decision-making in health services is that its implementation requires resources and time, which makes it difficult to use it for problems that require immediate solutions. In these situations, which are very frequent when it comes to the health of groups and populations, only the existence of accumulated knowledge, resulting from past or previously planned assessments, can contribute to this decision-making (Tanaka, Tamaki, & Felisberto, 2012).…”

“…When it comes to the Unified Health System (SUS) in Brazil, the development of managerial instruments that seek "more objective" decision-making to put into practice the principles of universality, comprehensiveness and equity has been defended (Tanaka, Tamaki, & Felisberto, 2012), especially in the historical context in which it seeks to establish a "new public administration" focused on results (Garces & Silveira, 2002), as it has been titled in the literature as "the new public management" (Exworthy, 2010).…”