Machado Sérgio Pinto, Kuchenbecker Ricardo
Hospital de Clínicas de Porto Alegre, Porto Alegre, RS.
Cien Saude Colet. 2007 Jul-Aug;12(4):871-7. doi: 10.1590/s1413-81232007000400009.
The changing process of health care services affects the University Hospitals (UH) in a particular manner. This paper aims to analyse the challenges and future perspectives of the Brazilian UH. In order to do so, only the UH affiliated to the Brazilian Federal Teaching Institutions were analysed. There is a substantial heterogeneity amongst UH in Brazil, in terms of size and organizational structure as well as in the type of health care provided. Brazilian UH represent core elements of two State policies: Education and Health. Consequently, the existing tensions between these two policies, to some extent, often reflect on the UH. Also, the UH must frequently address challenges that go beyond their purpose. Organizational sustainability remains a crucial issue to the UH. This concept entails effective financial and management skills, outcomes monitoring and evaluation mechanisms, and accountability. UH in Brazil have two main roles: providing health care and integrating the National Health System. From a future perspective, the UH shall be conceived from a much broader perspective than that of institutions that only provide health care. The future of Brazilian UH relies on their capacity to provide effective support to the State Health and Education policies.
医疗保健服务的变革过程对大学医院（UH）产生了特殊影响。本文旨在分析巴西大学医院面临的挑战和未来前景。为此，仅对隶属于巴西联邦教学机构的大学医院进行了分析。巴西的大学医院在规模、组织结构以及所提供的医疗保健类型方面存在很大差异。巴西的大学医院是两项国家政策（教育和卫生）的核心要素。因此，这两项政策之间现有的紧张关系在一定程度上常常反映在大学医院身上。此外，大学医院必须经常应对超出其宗旨的挑战。组织可持续性仍然是大学医院的一个关键问题。这一概念需要有效的财务和管理技能、成果监测和评估机制以及问责制。巴西的大学医院有两个主要作用：提供医疗保健和整合国家卫生系统。从未来的角度看，大学医院的构想应比仅提供医疗保健的机构更具广阔视野。巴西大学医院的未来取决于它们为国家卫生和教育政策提供有效支持的能力。
