Public hospitals management: a study on the bureaucratic and outsourcing managing models in the state of Bahia.

by de Souza, Iracema Sena

This work aims at the comparing the different managing models adopted in different public hospitals in the State of Bahia: the bureaucratic and outsourcing managing models. This Master?s Degree Final Work is based on Max Weber?s bureaucracy theoretical framework, officially adopted in Brazilian public services from the time of the 1936 Administrative Reform and on the New Managerial Approach within the context of the State Reform implanted in 1995 in Brazil. The field work research focused on 19 state public hospitals, 11 of which follow the bureaucratic managing model and 8 the outsourcing managing model, by using the exploratory comparative research method of descriptive type and quantitative approach. The empirical study was developed through data collection, tabulation, analysis and comparison of indicators characterizing management models (manager?s profile and usage of traditional managing practices) and usage of contemporary managing practices. As observed, in practice, there is correspondence between bureaucracy theoretical frame and SESAB?s direct administration hospitals, as well as between outsourcing managing model hospitals and the New Managerial approach. Results yield that the transition from the bureaucracy managing model to the outsourcing model caused changes not only in respect to manager?s profile and professional degree, but also in terms of usage of managing traditional practices ( as, for instance, people managing tools, budget and supplies) and in terms of the usage of contemporary managing practices. The latter are mainly represented in the implementation of SUS and the perspective of the New Managerial approach (Quality and Information Technology Programs). The research indicates that in order to reach SUS and the State Reform objectives it is not necessary to have public-private partnerships. Basically, it suffices having political interest in the professional management of public hospitals, so that they may excel in the quality of services offered, associated with correct resource management and cost reduction.