CONTRACTUAL ARRANGEMENTS IN HOSPITALS TO OPTIMIZE THE MANAGEMENT OF HEALTH CARE SERVICES

• Grant number: 23/10122-8
• Support Opportunities: Research Grants - Research in Public Policies
• Start date: May 01, 2025
• End date: April 30, 2028
• Field of knowledge: Applied Social Sciences - Administration - Public Administration
• Principal Investigator: Ana Maria Malik
• Grantee: Ana Maria Malik
• Host Institution: Escola de Administração de Empresas de São Paulo (EAESP). Fundação Getúlio Vargas (FGV). São Paulo , SP, Brazil
• Associated researchers: ALESSANDRO RANULFO LIMA NERY ; Anny Karine de Medeiros ; Diego Camargo Botassio ; Klenio de Souza Barbosa ; Maísa Cristina Dante Fagundes ; Rafael Igrejas da Silva ; RAQUEL PEREIRA PONTES ; Renato Eliseu Costa ; Ricardo Tardelli ; Yan Nonato Cattani

Abstract

The health services provided by the SUS are diverse, ranging from Primary Care, with Basic Health Units, to Health and Epidemiological Surveillance actions, in addition to involving the responsibilities of the three federative entities. They must cover health promotion, protection and recovery in order to comply with the constitutional guideline of "comprehensive care, with priority for preventive activities, without prejudice to care services" (art. 198, item II, of the Federal Constitution). With these several activities, the most expensive health units are hospitals, for which, of course, the complexity of the services offered by the hospital will be directly proportional to their costing amounts. Taking into account this information, this project aims to study the contractual arrangements in hospitals in the State of São Paulo, specifically those involving non-assistance management "gray coat" through the conclusion of Public-Private Partnerships (PPPs), a more recent model that presents adaptability challenges in terms of operation management, especially due to the inevitable changes in the care profiles of hospital units. The objective of the project is the elaboration of a Decision Support Model (DSSM) that assists public managers in defining the ideal types of services (care and/or non-care) in hospitals managed under the PPP model and the determination of the ideal number of contracts to structure this offer. The study aims to analyze international PPP models in the health area, report and analyze PPP contracts signed in Brazil, develop a qualitative and quantitative Value for Money (VfM) model, as well as provide parameters for the comparison of management models in the health area. The expected results include an analytical model of PPP contracts in Brazil, parameters of economic-financial and operational performance indicators, as well as the organizational design for the management of a PPP contract in the health area. More specifically, the proposal is to have a model of analysis of the current context, to have a list of the items of PPP contracts, to make an analysis and a comparison of the models. The proposal is not to create a new type of contract. In terms of scientific results, the project aims to verify whether and how existing management arrangements promote improvements in the efficiency and quality of health services provided.The Partner Institution in this project is the São Paulo State Health Department (SES-SP), the state agency responsible for formulating the State Health Policy and its guidelines, guided by the principles of the Unified Health System (SUS). The academic counterpart is carried out by the Host Institution, in this case FGV-SP, supported by PSP HUB researchers. (AU)