As organizações sociais de saúde em São Paulo, 1998-2002: uma visão institucional

• Ano de defesa: 2003
• Autor(a) principal: Seixas, Paulo Henrique D'Ângelo
• Orientador(a): Malik, Ana Maria
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Contrato de gestão; Organizações sociais; Terceiro setor
• Link de acesso: http://hdl.handle.net/10438/2214

This paper aims to describe the implementation process of the 'Organizações Sociais de Saúde' (Social Health Organizations) in São Paulo's State Department ofHealth as a special case of Health State Reforrn. It identifies the drivers and rationale of the State and partners engaged, and describes the negotiation and implementation process of the Organizações Sociais de Saúde, defining: a) specific regulation/legislation; b) negotiation and formalization of the partnerships; c) implementation phases; d) funding mechanisrns: e) facilitating factors and hindrances; f) considerations about the processes obtained bv the parties involved. Literature review on the theme was followed by a case study involving the State Department ofHealth and seven non-profit organizations with which it formed partnerships to manage public hospitaIs in Metropolitan São Paulo. The organizations, with different care profiles, formed partnerships through management contracts. The study identified the differences between these contracts and those suggested by the State Apparatus Reform, the motivations that guided partners, funding mechanisms used, and the careful negotiation process that provided stability to the partnership. The paper reports and analyzes the perceptions of the managers of the Organizações Sociais de Saúde, of the State Department of Health and of hospital senior management about the development of the partnership, its strengths, weaknesses, and the prospects for implementing them at city level. The partnership provided significant institutional gains for both sides, and offered the conditions for the development of diverse care modalities and other partnerships with the communities involved. However, it is necessary to continuously improve management contracts and the relationships with the system managers so as to permit that the performance improvements accomplished reflect in the remaining of the network and be sustainable in the long termo.