Estratégias hospitalares e o PRO HOSP: uma análise da parceria público-privada com o Estado de Minas Gerais

Abstract

This study aimed to demonstrate the strategies adopted by three hospitals participating in a program directed towards the health and reconstruction of the hospital park in Minas Gerais: Pro Hosp (Program for the Improvement and Strengthening of Philanthropic Hospitals in Minas Gerais). Based on the perspective of public-private partnerships (PPPs), the program uses targets and performance indicators to evaluate the participating hospitals. The institutions have signed a contract of goals and objectives (contracting) and receive funding according to the scope of these. This is an initiative of the Government of Minas Gerais, based on the principles of New Public Management (NPM), through which management practices and analysis of the efficiency, effectiveness, control and results are applied to the management of public properties. Another aim was to demonstrate how and which resources were mobilized in organizational management strategies adopted by surveyed hospitals, with a view to achieving certain goals and objectives established by the program, adopting the theoretical RBV (Resource Based View). Interviews were conducted with managers of three institutions participating in the program through a set of interviews made from common goals and objectives to all hospitals, as well as the types of resources taken by Grant (1991) forming a framework of variables to be analyzed in each interview. The interviews were taped and transcribed and the data were analyzed by content. This study was structured in the form of three articles, where the first is a reconstruction of a form of state intervention in health. The second one deals specifically with the use of PPPs as a contemporary form of intervention and the use of performance indicators for monitoring these partnerships. It demonstrates a frame constructed from indicators of Pro Hosp achieved in the three hospitals, revealing their adaptations to the program and this as an incentive to build a system and important information not previously recognized by the institution. The third and final article deals with strategies and resources mobilized to achieve these and other indicators of Pro Hosp objectives, such as the construction of the Master Plan. The results demonstrate strategies aligned with the difficulties of each institution, and affirm the importance of human resources in the provision of health services. This study is believed to represent the "awakening" to other studies that show important points for discussion and implementation of public policies aimed at health.