Parceria público-privada: fatores (des) favoráveis para a gestão dos contratos em saúde no governo do estado de São Paulo / Cleber Vieira da Silva

Abstract

The Regional Hospital of Sorocaba is the State of São Paulo’s first public-private partnership hospital. The administrative concession contract No. 01/2014 was signed between Inova Saúde Sorocaba SPE S/A and the State of São Paulo Health Department (SES-SP), and has the characteristic of building, maintaining and operating non-healthcare services (gray coat) of the hospital complex. This shared management model foresees the participation of a social health organization to manage the healthcare service actions (white coat), which makes this partnership ideal. This study aims to understand the characteristics of PPP healthcare contracts of a public hospital operating in Brazil, in the PPP modality, identifying favorable and unfavorable factors in the management of administrative concession contracts. A case study protocol was adopted to conduct semi-structured interviews, document analysis and the analysis of content in order to understand the profile of the professionals involved, check how PPP projects are developed, and analyze the process of carrying out PPP healthcare contracts. The findings of this study show that there’s room for the state to seek greater integration with private partners, actively participating in the PPP Management Committee management. The periodic review of the concession contract might be a solution in determining a rate of occupation aimed at achieving the efficiency expected for PPP contracts. There’s still a lack of clarity in the evaluation of the private partner’s results regarding the achievement of goals and performance indicators provided for in the concession contract, and it’s up to the state to define in advance, the cost and periodicity of hiring an independent auditor in the annual consideration. The presence of information and communication technology (ICT) has added quality to the execution of healthcare services, which can be replicated in other PPP healthcare contracts.