ABSTRACT
PURPOSE: This paper aimed to contextualize the process of public hospital providing services, based on the measurement of the performance of Federal University Hospitals (HUFs) of Brazil, using the technique of multivariate statistics of principal component analysis. DESIGN/METHODOLOGY/APPROACH: This research presented a descriptive and quantitative character, as well as exploratory purpose and followed the inductive logic, being empirically structured in two stages, that is, the application of principal component analysis (PCA) in four healthcare performance dimensions; subsequently, the full reapplication of principal component analysis in the most highly correlated variables, in module, with the first three main components (PC1, PC2 and PC3). FINDINGS: From the principal component analysis, considering mainly component I, with twice the explanatory power of the second (PC2) and third components (PC3), it was possible to evidence the efficient or inefficient behavior of the HUFs evaluated through the production of medical residency, by specialty area. Finally, it was observed that the formation of two groups composed of seven and eight hospitals, that is, Groups II and IV shows that these groups reflect similarities with respect to the scores and importance of the variables for both hospitals' groups. RESEARCH LIMITATIONS/IMPLICATIONS: Among the main limitations it was observed that there was incomplete data for some HUFs, which made it impossible to search for information to explain and better contextualize certain aspects. More specifically, a limited number of hospitals with complete information were dealt with for 60% of SIMEC/REHUF performance indicators. PRACTICAL IMPLICATIONS: The use of PCA multivariate technique was of great contribution to the contextualization of the performance and productivity of homogeneous and autonomous units represented by the hospitals. It was possible to generate a large quantity of information in order to contribute with assumptions to complement the decision-making processes in these organizations. SOCIAL IMPLICATIONS: Development of public policies with emphasis on hospitals linked to teaching centers represented by university hospitals. This also involved the projection of improvements in the reach of the efficiency of the services of assistance to the public health, from the qualified formation of professionals, both to academy, as to clinical practice. ORIGINALITY/VALUE: The originality of this paper for the scenarios of the Brazilian public health sector and academic area involved the application of a consolidated performance analysis technique, that is, PCA, obtaining a rich work in relation to the extensive exploitation of techniques to support decision-making processes. In addition, the sequence and the way in which the content, formed by object of study and techniques, has been organized, generates a particular scenario for the measurement of performance in hospital organizations.
Subject(s)
Hospitals, University , Principal Component Analysis , Brazil , Humans , Hospitals, PublicABSTRACT
O exercício do controle social é uma das formas de prática democrática aplicada ao sistema de saúde pública no Brasil. Dentre os mecanismos para o seu exercício, tem-se os relatórios de prestação de contas de natureza econômico-financeira. Tais relatórios são elaborados pelas Secretarias de Saúde e submetidos à deliberação de seus respectivos Conselhos de Saúde, como um dos meios à concretização da transparência dos atos públicos. Este artigo versa sobre uma análise comparada dos relatórios de prestação de contas das Secretarias Estaduais de Saúde, permitindo dessa forma a descrição de possíveis melhorias no processo de divulgação de tais informações. A presente pesquisa se caracteriza pelo tipo documental e natureza qualitativa. Foram analisados os relatórios de prestação de contas dos exercícios de 2008 e 2009 dos seguintes Estados: Paraná, Santa Catarina, Rio Grande do Sul, Espírito Santo e Rio de Janeiro. Os resultados sugerem que, apesar de as Secretarias Estaduais divulgarem a maioria das variáveis avaliadas, os Conselhos de Saúde não materializam a análise da gestão pública em seus pareceres, demonstrando que o processo de avaliação das informações carece de melhorias acerca de sua interpretação e recomendações de melhorias das políticas públicas em saúde. No que tange à prestação de contas, aspectos como: definição de prioridades na destinação de recursos e estabelecimento de metas e objetivos ainda não fazem parte da maioria dos relatórios estaduais. Como sugestão para pesquisas futuras, poder-se-á analisar se a amplitude de participação dos conselhos influencia na melhoria dos relatórios de prestação de contas.
