Gestão estratégica nas organizações públicas de saúde : um estudo de caso da consolidação do SUS Municipal

Abstract

The study, in its initial part, aims to relate aspects of the organizational theory and the main tools for administrative management. In sequence, it shows the complexity of the Brazilian Public Health system - SUS - and relates the main factors that permeate the management of the Public Health sector, emphasizing the issues of the three level government agents, which integrate it. As a basic element of this survey, it was developed a case study of a Health Public Organization at municipal level. In this case it was analyzed, with emphasis, the management actions related to the financial and administrative resources from the Municipal Health Fund, which allowed the effectuation of strategic actions for a Municipal Public Health Model consolidation. In the structuring of the case, the applied methodology embraced large documental and bibliographic survey, which was joined by the execution of openstructured interviews with administrators and managers who acted during different periods of the public management, between 1983 and 2000, towards the referred Health program. Those interviews provided subsidies for the identification and rating of the actions, which consolidated the adopted policies and strategies, and moreover, the formation of the reference basis for the data structuring necessary to the evaluation of the accomplished results by this Municipal Health System. All those elements based the historical evolution course study of the Municipal Health System, through constant growth of the physical and human basis, either under qualitative or quantitative criteria, the importance of the non-centralized establishment and operational management of the Municipal Health Fund and, finally, the different strategies implemented, characterized by the actions that allowed the increase in the offer of the Municipal SUS s services, main objective of the System.