Gestão da qualidade nos serviços públicos de saúde: uma abordagem multidimensional
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2016-08-01
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O complexo desafio inerente à gestão das instituições de saúde públicas no Brasil realça o interesse e o contributo dado pela pesquisa empírica, dando ênfase ao processo de gestão da qualidade dos serviços prestados. No Brasil, o cuidado com a saúde faz parte das atribuições governamentais desde que o Estado brasileiro se constituiu. A inquietude nos gestores, dirigentes e profissionais da área de saúde originadas pela forma de gerir a qualidade nas organizações de saúde, reflete o descompasso existente entre as práticas de gestão, as exigências das organizações e as necessidades dos profissionais e dos usuários (utentes). Este projeto trata-se de uma pesquisa transversal, de natureza quantitativa, que tem como objetivo central avaliar a gestão da qualidade do serviço prestado por instituições públicas de saúde numa abordagem multidimensional; ou seja, avaliar as várias dimensões da qualidade na atenção primária (Postos de Saúde) e secundária (Hospital Municipal) e reconhecer sua importância para que haja uma melhoria no gerenciamento de programas e projetos vinculados aos processos de planejamento, monitoramento e avaliação na gestão da saúde pública. O estudo foi realizado nos três postos de saúde e no Hospital Municipal Maria Zélia no município de Marcelândia, estado do Mato Grosso. O instrumento conceitual foi o modelo SERVPERF. Dos 300 usuários entrevistados, o gênero feminino com 226 (75,3%) foi mais predominante que o masculino com 74 (24,7%). A maioria dos usuários se enquadra na idade média, (31- 45 anos), com 108 (36%), com a minoria idosa, com 52 (17,3%). O grau de escolaridade dos usuários é baixo, a maioria com ensino básico, com 105(35%), e a minoria são formados em nível superior, com 7(2,3%). Foram extraídas 3 dimensões da qualidade da análise fatorial: Qualidade Global, Qualidade dos Serviços e Tangibilidade. Através da regressão linear, obtivemos os seguintes dados: os usuários do Hospital concordam muito mais pela opinião de uma Boa Qualidade Global quando comparado aos usuários do Posto de saúde 1(coeficiente estimado 0,787). Acham Bom a Qualidade dos Serviços nas 4 unidades e quanto a Tangibilidade, acham Satisfatório nos postos de Saúde 1 e 3 e Bom no Hospital Municipal e Posto 2. A Tangibilidade foi considerada a de menor satisfação. A avaliação efetuada pelos usuários dos serviços públicos revelou-se muito positiva, pois fornecem indicadores importantes sobre em qual dimensão os gestores devem atuar diante da satisfação ou insatisfação dos mesmos.
The complex challenges inherent in the management of public health institutions in Brazil highlights the interest and the contribution made by empirical research, emphasizing the process of managing the quality of services provided. In Brazil, the health care is part of government functions since the Brazilian government was formed. The restlessness in managers, leaders and professionals in health caused by the way of managing the quality of health organizations, reflects the mismatch between management practices, the demands of organizations and the needs of professionals and users (users). This project it is a cross-sectional, quantitative in nature, which is mainly aimed to assess the management of quality of service provided by public health institutions in a multidimensional approach; ie assess the various dimensions of quality in primary care (health centers ) and secondary (Municipal Hospital) and recognize its importance so that there is an improvement in the management of programs and projects related to planning, monitoring and evaluation in health management public. The study was conducted in three health and the Municipal Hospital in the Municipality of Maria Zelia Marcelândia, state of Mato Grosso. The conceptual instrument was the SERVPERF model. Of the 300 users surveyed, with 226 females (75.3%) was more prevalent than males, with 74 (24.7%). Most users will not fit in middle age (31- 45 years), with 108 (36%), with the elderly minority, with 52 (17.3%). The level of education of users is low, mostly with basic education, with 105 (35%), and the minority are formed on the upper level, with 7 (2.3%). Global Quality, Quality of Service and Tangibility: 3 dimensions of quality of factor analysis were extracted. Linear regression, we obtained the following data: users Hospital agree more on the opinion of a Global Good quality when compared to users of Dispensary 1 (estimated coefficient 0.787). Good think the Quality of Services in the 4 units and as tangibility, find jobs in Satisfactory Health and Well 1 and 3 at the Municipal Hospital and Tour 2. The Tangibility dimension was considered the least satisfied. The assessment made by the users of public services has been very positive, as they provide important indicators about which dimension managers should act on the satisfaction or dissatisfaction of the same.
The complex challenges inherent in the management of public health institutions in Brazil highlights the interest and the contribution made by empirical research, emphasizing the process of managing the quality of services provided. In Brazil, the health care is part of government functions since the Brazilian government was formed. The restlessness in managers, leaders and professionals in health caused by the way of managing the quality of health organizations, reflects the mismatch between management practices, the demands of organizations and the needs of professionals and users (users). This project it is a cross-sectional, quantitative in nature, which is mainly aimed to assess the management of quality of service provided by public health institutions in a multidimensional approach; ie assess the various dimensions of quality in primary care (health centers ) and secondary (Municipal Hospital) and recognize its importance so that there is an improvement in the management of programs and projects related to planning, monitoring and evaluation in health management public. The study was conducted in three health and the Municipal Hospital in the Municipality of Maria Zelia Marcelândia, state of Mato Grosso. The conceptual instrument was the SERVPERF model. Of the 300 users surveyed, with 226 females (75.3%) was more prevalent than males, with 74 (24.7%). Most users will not fit in middle age (31- 45 years), with 108 (36%), with the elderly minority, with 52 (17.3%). The level of education of users is low, mostly with basic education, with 105 (35%), and the minority are formed on the upper level, with 7 (2.3%). Global Quality, Quality of Service and Tangibility: 3 dimensions of quality of factor analysis were extracted. Linear regression, we obtained the following data: users Hospital agree more on the opinion of a Global Good quality when compared to users of Dispensary 1 (estimated coefficient 0.787). Good think the Quality of Services in the 4 units and as tangibility, find jobs in Satisfactory Health and Well 1 and 3 at the Municipal Hospital and Tour 2. The Tangibility dimension was considered the least satisfied. The assessment made by the users of public services has been very positive, as they provide important indicators about which dimension managers should act on the satisfaction or dissatisfaction of the same.
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Dissertação de Mestrado em Gestão dos Serviços de Saúde
Palavras-chave
Saúde pública , Gestão , Brasil , Gestão da qualidade , Serviços de saúde