Impactos nos níveis de eficiência no Hospital Universitário de Santa Maria: antes e após a contratação da EBSERH

Abstract

Federal University Hospitals (HUFs) are organizations that play a fundamental role in the brazilian health care network, mainly because they have medium and high complexity health care and the development and training of professionals in the public health area, through education, research and extension, as assumptions. HUFs are part of the Brazilian organizational structure of federal higher education institutions. They are linked to the Ministry of Education for its teaching aspect and to the Ministry of Health for linking to the public health system. However, as a result of the economic crisis in the health system that affected brazilian university hospitals in 2010, the National Federal University Hospitals Restructuring Program (REHUF) was created, consisting of a government proposal aimed at guaranteeing the physical recovery and the restructuring of the human resources framework in the hospitals. As one of the actions of REHUF, in 2011, the Brazilian Hospital Services Company (EBSERH) was created, an alternative of the federal government to solve the problems faced in the management of federal university hospitals. Nowadays, this company is responsible for the management of 40 of the 50 hospitals, linked to 35 federal higher education institutions. Based on the assumption that the company created aims to solve problems that resulted in the crisis in the HUFs, the main objective of this research was to answer the following question: the changes that have occurred since the contracting of EBSERH have made the University Hospital of Santa Maria (HUSM) more efficient, especially in terms of performance and technical efficiency? The methodology used was the narrative research, with applied nature, and quantitative and quantitative approach, exploratory and descriptive character, using the following techniques: bibliographical and documentary research, field research at HUSM’s and Federal University of Santa Maria’s (UFSM) units, searches on the internet and federal government systems. The study was conducted at HUSM, a unit subordinate to UFSM and one of the hospitals under the management of EBSERH. In addition to the comparative research between the various aspects that surrounds the operation of HUSM, Data Envelopment Analysis (DEA) was applied in the period of the research, as a way of assessing the technical efficiency indices in the HUSM’s management before and after EBSERH’s hiring, between 2007 and 2016. Although the results of the application of the DEA method have indicated that six of the ten decision making units (DMUs) (2007 to 2016) are at the efficiency frontier, and, of these 6, the most efficient DMU was in 2011, all the context analyzed (structure, processes and people), as well as the results of the research, indicates a tendency to improve technical efficiency, mainly by equalizing the diagnosed macroproblems, such as the personnel, physical and technological infrastructure and processes organizations.