Bulhões Bárbara, Bellas Hugo, Arcuri Rodrigo, de Carvalho Paulo Victor Rodrigues, Jatobá Alessandro
Instituto de Medicina Social Hesio Cordeiro (IMS) - Universidade do Estado Rio de Janeiro (UERJ) -, Rio de Janeiro, Brazil.
Centro de Estudos Estratégicos Antônio Ivo de Carvalho (CEE) - Fundação Oswaldo Cruz ,Rio de Janeiro, Brazil.
Dialogues Health. 2022 May 14;1:100011. doi: 10.1016/j.dialog.2022.100011. eCollection 2022 Dec.
In Brazil, public hospitals are managed according to several different models. The participation of private or third-sector organizations has been growing in a significant manner, especially in the past decade. The present study explores the perception of public administrators and health councilors on the main aspects of outsourcing the management of public health services to the private sector. The study shows that the main disadvantages are related to the reduction of the State's role as regulator, making it more difficult to size services up according to the demands of the population. Among the main advantages pointed out are contributions to reduce bureaucracy in the administration and more freedom for the management of physical, financial, and human resources. The present study contributes to transcend the political-ideological discussion on private sector participation in the management of public and universal constitutionally guaranteed services, presenting the point of view of administrators in Brazil, not very explored in recent literature.
在巴西,公立医院按照几种不同模式进行管理。私人或第三部门组织的参与度一直在显著增长,尤其是在过去十年。本研究探讨了公共管理人员和卫生顾问对将公共卫生服务管理外包给私营部门的主要方面的看法。研究表明,主要缺点与国家作为监管者的角色削弱有关,这使得根据民众需求调整服务规模变得更加困难。所指出的主要优点包括有助于减少行政中的官僚作风,以及在管理物质、财务和人力资源方面有更大的自由度。本研究有助于超越关于私营部门参与管理公共的、宪法保障的全民服务的政治意识形态讨论,呈现巴西管理人员的观点,而这在近期文献中并未得到充分探讨。