Desenho organizacional da rede de agentes que envolvem as parcerias público-privadas de saúde na Região Metropolitana de Salvador

Abstract

Este trabalho analisou as parcerias público-privadas (PPPs) stricto sensu de saúde existentes na Região Metropolitana de Salvador (RMS) (Hospital do Subúrbio, Instituto Couto Maia e Diagnóstico por Imagem) e identificou os agentes públicos e privados que envolvem essas concessões. Além disso, construiu um mapa de rede com o objetivo de delinear um desenho organizacional que compreende esses agentes, bem como investigou a quem se destinam as maiores responsabilidades desse sistema: se para o Estado ou para empresas privadas. Os resultados mostraram que existe uma heterogeneidade de agentes públicos e privados na rede das PPPs de saúde da RMS. Essa rede forma uma estrutura de poder dinâmica e com escalas de atuação predominantemente local e regional. Os resultados também evidenciaram que as maiores responsabilidades são do setor público.

Public-private health and urban mobility partnerships in the State of Bahia: current situation, projects and main agents involved

“…The conclusion reached herein agrees with that of Silva, Carvalho and Oliveira (2019), that is, the greatest responsibilities are directed to the public sector. We found that the government of Bahia is largely responsible for preparing projects, and is also the incentive and fundamental agent in this process, since it allows and legitimizes the strategies of private agents, regulates, supervises and creates funding channels, which are mostly carried out by public agencies, and pays the bills through monthly pecuniary payments and resource and remuneration fees.…”

“…Regarding methodology, this study followed an exploratory-descriptive qualitative approach and used comparative and monographic procedures. Therefore, the following steps based on methods adopted by Silva, Carvalho and Oliveira (2019), were used and are synthesized in Figure 1: 1) National and international bibliographic survey: books, book chapters, dissertations, theses, well-qualified articles and events. 2) Document review of norms and laws from Brazil, specifically Bahia, about PPPs, on official state and federal government websites.…”

“…2) Experiences of PPPs in Brazil. Barbosa, Cabral and Loiola (2009) analyze the risk mitigation process in the Jaguaribe Ocean Disposal System project, which covers Salvador and Lauro de Freitas; Moreira (2012) works from the perspective of territorial development with the case study of the metrorail sector in the Metropolitan Region of São Paulo; Peci, Godoy, Rodrigues et al (2012) indicate the main factors that influence the adoption of PPPs contracts, working with the cases of the MG-050 highway, the Penal Complex of the Metropolitan Region of Belo Horizonte and the campus of the State University of Minas Gerais (UEMG); Carrera (2014) analyzes the merits of health sector projects in Brazil;Cabral, Fernandes and Ribeiro (2016) research the roles of stakeholders in the implementation of PPPs in Bahia, focusing on experiences in the areas of health, sanitation and sport/culture; Barbosa and Malik (2015) analyze profiles, critical factors, limitations and trends of different health PPP contracts in Brazil; Rodrigues and Zucco (2018) evaluate the experience of the municipality of Belo Horizonte in the construction and operation of school infrastructure through PPPs; Silva, Carvalho and Oliveira (2019) ponder the organizational design of the network of agents involving health PPPs in the Metropolitan Region of Salvador.…”

“…For this, some relevant question were asked, based on the work of Silva, Carvalho and Oliveira (2019): Who drew up the projects? Who financed them?…”