| dc.description.abstract | ABSTRACT
Introduction: To evaluate the performance of the Organizational Management
of Hospital Services in Brazil is relevant because the organizational management
actions provide adequate operation, planning, and organization to hospitals as
well as physical, technological, material, and human conditions that influence the
care results. Considering the large number of hospitals that are part of the
Brazilian Unified Health System and the importance of these services in the
population health care, it becomes relevant to evaluate them from an
organizational management standpoint.
Objective: To evaluate the performance of the Organizational Management of
Hospital Services in Brazil.
Method: Cross-sectional study that used secondary data from the 2015-2016
National Health Services Evaluation Program to evaluate the Organizational
Management Performance of 1665 hospitals in Brazil from 30 verification items
referring to Contract Management, People, Information, Planning and
Organization, Organizational Model, which constituted an evaluation score of the
hospitals. The Performance was evaluated according to the indicators: hospital
size, level of complexity, administrative system, type of management and region
of the country. It was verified the association between Performance of
Organizational Management of hospitals with indicators such as: Occupancy
Rate, Average Length of Stay, Hospital Mortality Rate and Average Value of
Hospital Admission Rate. We used Main Components Analysis in order to verify
the dependent relationship among variables and to explain data variability. The
adjusted logistic regression model was estimated to verify the variables that best
explain the Organizational Management Performance.
Results: The average of Organizational Management Performance of the
hospitals was 63.83. In the evaluation by criteria the following results were
obtained: Information Management (77.59), People Management (61.96),
Contract Management (61.71), Organizational Model (61.64), Planning and
Organization (56.45). The best results were seen in hospitals in the South region,
Complexity level 8, above 150 beds, Federal Public Administrative System and
State Management. In the logistic regression analysis the variables that most
explain Organizational Management Performance are: Occupancy Rate
(p<9.87E-09), Hospital Size (p<4.49E-10), Municipal Management (p<0.004),
Hierarchical Level- Level 7 (p<0.042), Level 8 (p<0.022) Southern region
(p<0.004), Southeast (p<0.002).
Conclusion: The study shows that the PNASS is a powerful and qualified
instrument for evaluating hospitals. Important gaps in the Organizational
Management of Hospitals in relation to the PNASS criteria were highlighted. It
also points to the relationship between scale and efficiency. Moreover, the study
reinforces the regional inequality by concentrating hospitals in the South and
Southeast regions in quantitative and qualitative terms, besides demonstrating
the need for further study on the management of hospitals under municipal
management given its insufficiency indicated in this study. | |
