Contratualização de serviços na rede hospitalar SUS: o caso de Salvador.

Abstract

Given the need for specialists and technological apparatus, the provision of hospital services of medium and high complexity (MAC) in the Unified Health System (SUS) has important participation of the non-profit private sector, through a contracting process for the provision of specialized services. As a result, the contracting public manager becomes required to monitor the contractual relationship, which is sometimes permeated by conflicts related to noncompliance with agreements. Thus, this study aimed to contract medium and high complexity hospital and outpatient services by the Municipal Health Department of Salvador, Bahia, through the analysis of documents that make up the contract and semi-structured interviews with municipal management technicians and hospital representatives. who carry out the monitoring of the agreement, seeking to identify the emerging problems of the contractual relationship in the light of the principal-agent theory. The results showed that the most apparent problems are related to the monitoring and control process, which has become more complex with the current format of the agreement. In addition, a more detailed study of the singularities of each institution would promote greater impact on compliance with the results agreement.