Name: Gabriella Bigossi de Castro
Type: MSc dissertation
Publication date: 21/10/2019
Advisor:

Namesort ascending Role
Francis Sodré Advisor *

Examining board:

Namesort ascending Role
Maria Angelica Carvalho Andrade Internal Examiner *
Jonathan Gonçalves Filippon External Examiner *
Francis Sodré Advisor *
Elda Coelho de Azevedo Bussinguer External Alternate *
Adriana Ilha da Silva Internal Alternate *

Summary: Using the State ́s inability to take care of the demands directed to it as a justification and as a
form of criticism to its rigid, inefficient and bureaucratic public administration, the State ́s
reform of its public administration system has proposed the process of transferring the
execution of services that are not exclusive to the State over to Social Organizations. In spite
of limited empirical evidence regarding Social Organizations for Health (OSS), not only do
these organizations continue to make headway managing Brazil ́s Public Health System
(Sistema Único de Saúde – SUS) but they have also received large amounts of public
resources to do so. According to Article 16 of Law 4.320, from 1964, economical advantage
must be proven before a Third Sector organization receives public funding. The large number
of Additive Terms (AT) to the Management Contracts (MC) that have been identified in the
state of São Paulo (SP), which pioneered OSS management, has resulted in a need to
investigate the content of these documents regarding both the forwarding of financial
resources and the services which are offered. It is possible that the large number of AT may
increase the amount of public resources forward to OSS. Considering the history of the
private sector ́s interest in the Public Health System, this forwarding of resources might
motivate the OSS to seek partnerships with the State more than a mere interest in the
effectiveness of the Public Health System management. Having the Health planning as
proposed in the MC and AT established between 2013 and 2017 as the object of its study, this
research seeks to analyze the dynamic of resource forwarding and care goals stipulated in SP.
This study is exploratory and descriptive in nature, with quantitative and qualitative
approaches. A total of 27 OSS were identified in the management of 98 health
establishments. The total amount of forwarded to the management of 89 establishments
exceeded the amount stipulated in the MC by 6.23%; however, there was an average increase
of 20.22% in the transfer to 20 establishments. The most valuable service was Medical
Appointments. Neither qualitative nor quantitative goals were not met by OSS. More health
services were excluded than included and most care goals were reduced, especially regarding
Emergency Hospital Services and Ambulatory Dental Services. The price of the four main
services offered showed, when considered together, an average increase of 22.82%. These
partnerships seem to bring more benefits to the OSS, since the forwarding of resources
increase on a constant basis while health services offered to the population decrease, which
shows the need for further investigation.

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