Ravioli Antonio Franco, Soárez Patrícia Coelho De, Scheffer Mário César
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Cad Saude Publica. 2018;34(4):e00114217. doi: 10.1590/0102-311x00114217. Epub 2018 Apr 23.
The current study aimed to systematically analyze trends and priorities in the theoretical and conceptual approaches and empirical studies on specific health services management modalities in the Brazilian Unified National Health System. A narrative review of the literature identified, in 33 publications, the location and nature of services, management models, methodological procedures, and study outcomes. The research deals mainly with the models' conceptual and legal characteristics and management practices, in addition to addressing contracts, procurement, human resources, financing, and control mechanisms. In conclusion, the literature is limited and concentrated in the State of São Paulo, showing little theoretical diversity and methodological weaknesses, while it is nonconclusive as to the superiority of one management model over another. New evaluation studies are needed that are capable of comparing different models and assessing their performance and their effects on the quality of health services' provision, the population's health, and the health system's organization.
当前的研究旨在系统分析巴西统一国家卫生系统中特定卫生服务管理模式的理论与概念方法以及实证研究的趋势和重点。一项文献叙述性综述在33篇出版物中确定了服务的地点和性质、管理模式、方法程序以及研究结果。该研究主要涉及这些模式的概念和法律特征以及管理实践,此外还涉及合同、采购、人力资源、融资和控制机制。总之,文献有限且集中在圣保罗州,理论多样性不足且方法存在缺陷,同时关于一种管理模式优于另一种管理模式尚无定论。需要开展新的评估研究,以比较不同模式并评估其绩效以及对卫生服务提供质量、人群健康和卫生系统组织的影响。