Sobre os impasses dos usos da avaliação para a gestão: não é preciso inventar, nem basta simplificar

Conill, Eleonor Minho

doi:10.1590/s1413-81232012000400005

Cited by 6 publications

(6 citation statements)

References 3 publications

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“…Essa cooperação entre as esferas municipal e estadual delimita um complexo quadro de necessidade e uso, bem refletido na separação dos objetos avaliativos em níveis: macro, que lida com formulação de políticas; o meso com a sua operacionalização na gestão; e o micro, que atua na prática dos prestadores de serviços de saúde, e permite identificar distintas lógicas de interação e ação social, que demandam indicadores específicos e estratégias de mudança diferenciadas 19 . Enquanto a SES propõe uma avaliação da gestão da atenção básica, no nível macro, os municípios agem nos planos meso e micro com a definição de estratégias para cumprir o planejamento da política estadual implantada.…”

Section: Discussionunclassified

O uso de uma avaliação por gestores da atenção primária em saúde: um estudo de caso no Sul do Brasil

et al. 2014

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Section: Discussionunclassified

O uso de uma avaliação por gestores da atenção primária em saúde: um estudo de caso no Sul do Brasil

et al. 2014

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“…In some systems, the strong party-political influences with high turnover, discontinuity and management technical disqualification are classic barriers of dynamic systems to the health systems performance (Conill, 2012), therefore, we are once again justified in the need to look at these actors and their intrinsic interests to the performance evaluation of these systems. For each component or function of health systems, there is a set of social relationships that interfere with their dynamics.…”

Section: Control Function and Difficulties In Assessing The Performanmentioning

confidence: 99%

“…However, the performance incentives based strategies have increased. An example is the ranking system implemented in England, since the year of 2000, in which hospitals were assigned stars, with the results public and establishing sanctions or benefits as the establishment fulfill goals (Conill, 2012). Thus, the complexity of the health assessment process is reduced to the performance, and the performance is reduced to a mere ranking of the organizations.…”

Section: Introductionmentioning

confidence: 99%

Avaliação de desempenho de sistemas de saúde e gerencialismo na gestão pública brasileira

Carnut

Narvai

2016

Saude soc.

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The logic of the new public administration considers health services as non-state activities, and therefore executable by private entities. In this scenario, the control function reaches the proscenium in the discussion about the consolidation of the Regulatory State. Thus, this study used the narrative review technique, described by Rothers, to create the web of an initial critique regarding the content that the administrative control of the State has been outlining in the health sector. The focus was on the direct way of contracting results, expressed in the performance evaluation of health systems. As a counterargument, we turned our attention to the complexity of the field, both from the point of view of the intense disagreement regarding key terms, as well as the methodological problems in the study of health systems. Furthermore, we have comments about the acting perspective that goes beyond the control function and the need for the scientific community to refocus on the topic. Keywords: Health System; Health Evaluation; State; Public Health; Unified Health System. Leonardo Carnut ResumoEm saúde, a lógica da nova gestão pública considera os serviços sanitários como atividades públicas não-estatais, portanto executáveis por entes privados. Nesse cenário, a função de controle alcança o proscênio na discussão sobre a consolidação do Estado Regulador. Assim, este estudo se utilizou da técnica da revisão narrativa descrita por Rothers para tecer uma crítica inicial ao conteúdo em que o controle administrativo do Estado vem delineando no setor saúde. O foco recaiu sobre a forma direta como a contratualização de resultados vem sendo expressa em avaliações de desempenho dos sistemas de saúde. Como contra-argumento, reforça-se a atenção à complexidade do campo tanto do ponto de vista do intenso dissenso sobre termos fundamentais como dos problemas metodológicos no estudo dos sistemas de saúde. Além disso, foram emitidos comentários sobre as perspectivas de atuação para além da função controle e a necessidade de a comunidade científica reorientar o tema. Palavras-chave:

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“…Something that seems to be a difficult issue to resolve due to the tension between the particular and the general. 29,30 In addition to the method, the issue resides in the object (health system). Extensive bibliographic reviews 31,32 on health systems, Hoffman et al identified 41 different theoretical frameworks.…”

Section: Introductionmentioning

confidence: 99%

A Meta-summarization of Qualitative Findings About Health Systems Performance Evaluation Models: Conceptual Problems and Comparability Limitations

Carnut

Narvai

2020

INQUIRY

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Due to the replacement of the issue of performance measurement in health policies worldwide this study identifies and analyzes the models for evaluating health systems performance. For this purpose, a systematic review of the literature on the topic “health systems performance evaluation” is done, making it compatible with a qualitative meta-synthesis of the type “meta-summarization.” It works with all databases related to the theme (PubMed, Scopus, EMBASE, PubAdm and Lilacs/Scielo). Portuguese, English, and Spanish are elected as language limit. Of the total number of articles (n = 32), 23 articles (71.8%) do not have a definition on “performance.” In those who have a definition, “performance” could be summed up in 6 central ideas. Among the most frequent subsidiary concepts that makes up the performance idea are the concepts of “efficiency” (11.9%), “quality” (9.5%) and “effectiveness” (7.1%). Six models were found in this review: “dashboard,” “balanced scorecard,” “open system model,” “PCATool,” “analyze dimension and performance indicators” and “standardized checklist and interview.” The “dashboard” was the most frequent performance evaluation model, found in 35.7% of studies. Only 25% of the reviewed studies presented the performance evaluation model applied specifically to health systems. Far from being configured as management tools useful to comprehension of health systems, these performance evaluation models have shortcomings that compromise their systemic evaluative power. This reinforces the inversion of reality in the relationship between quality and performance. Also, the performance evaluation models used try to adapt to the object, however in most them with relevant analytical problems compromising the specificities in depth of the health system under analysis. This generates inaccuracies and replaces the question about its use and their limitations to compare health systems.

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Sobre os impasses dos usos da avaliação para a gestão: não é preciso inventar, nem basta simplificar

Cited by 6 publications

References 3 publications

O uso de uma avaliação por gestores da atenção primária em saúde: um estudo de caso no Sul do Brasil

O uso de uma avaliação por gestores da atenção primária em saúde: um estudo de caso no Sul do Brasil

Avaliação de desempenho de sistemas de saúde e gerencialismo na gestão pública brasileira

A Meta-summarization of Qualitative Findings About Health Systems Performance Evaluation Models: Conceptual Problems and Comparability Limitations

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