Análise do modelo gerencial de um Hospital: a percepção dos usuários a partir da mudança da arquitetura organizacional

Abstract

The Unified Health System (SUS) is considered one of the largest public health organizations in the world. Its goal is to provide a quality health service to any citizen, going from ambulatory to any other complex procedure. However, after twenty five years of existence, in despite of its advances, SUS still has its difficulties. Some experiences have shown that such difficulties could be related to the public management system adopted in our country. Then, we sought the analyses and description of how the patients, doctors and managers of a hospital perceive the changes of the different levels of efficiency in services which use the organizational architecture change, through the study of a specific hospital whose administration has been given to a social organization. In order to understand the transformations occurred in the Brazilian public management from the year of 1995 with the Master Plan of Reformation from the State Apparatus, it has been done a theoretical review about the studies related to hospital organizations with emphasis in the Weberian bureaucratic model of management and its evolution towards a model of administration by targets, the so called ‘New Public Management’. Therefore, this work is about a qualitative research, in which, we prepared a series of semi structured interviews to comprehend the perception from the partakers and their opinions about the different levels of efficiency in services which use the organizational architecture change. We concluded that, when it comes to patients, their perceptions have to do with how long the attendance took and also how humanized they were treated. To doctors, the point of view is generally different. They perceive the change from the conditions they dispose to perform the medical care, and they consider relevant the hospital diagnose and support as well as the availability of medicine and other necessary instruments. Finally, we get that, from the managers’ view, the hospital care would achieve the level of excellence if the government distributed the patients in a more efficient form, so that each health unit could provide their due service under their capability