Luís Otávio Farias

Segmentação de mercados da assistência à saúde no Brasil

O artigo analisa a dimensao e segmentacao do mercado supletivo de assistencia a saude no Brasil e o perfil dos seus segurados. Na primeira parte, destaca alguns elementos conceituais necessarios a compreensao das caracteristicas do mercado em saude. Analisa brevemente a dimensao e o papel do setor privado de saude em paises membros da Organizacao para Cooperacao e Desenvolvimento Economico (OCDE) e compara com caso brasileiro. Em seguida, realiza um breve historico do setor supletivo de saude no Brasil e, por fim, apresenta uma analise do perfil dos segurados, tendo por base os microdados da Pesquisa Nacional de Amostra por Domicilio de 1998 (Pnad/ IBGE).

Proteção social no Brasil: o que mudou na assistência social após a Constituição de 1988

O trabalho discute as mudancas do componente assistencial da protecao social nas duas decadas que se seguiram a Constituicao de 1988. Discute as transformacoes da protecao e assistencia social nas ultimas decadas e os processos que, na decada de 1990, fizeram avancar os processos de reforma da politica assistencial social no Brasil, sem no entanto produzir grandes mudancas no modelo de oferta de servicos. A partir dos anos 2000, ha uma significativa expansao de recursos e de cobertura de beneficios e servicos na area assistencial. Argumenta que os programas de transferencia de renda, embora surgidos e difundidos em um contexto internacional de politicas restritivas, no Brasil, ao se integrarem a um sistema publico e universal de assistencia social, alargaram substantivamente o escopo da protecao social. Alguns efeitos da expansao do sistema de protecao social no Brasil sao apontados: diminuicao da desigualdade de renda; construcao da capacidade institucional na area da assistencia social; o significado social, politico e simbolico da inclusao de um amplo segmento populacional a um sistema publico de assistencia social por meio de uma estrutura de provisao fora dos tradicionais mecanismos de filantropia e clientelismo.

Interação e conflito entre categorias profissionais em organizações hospitalares públicas

The article discusses some data from a study on the opinions and perceptions of the labor situation and environment among health professionals and administrative workers at the Research Center of the Evandro Chagas Hospital (CPqHEC/FIOCRUZ) in Rio de Janeiro. Certain patterns of conflict observed in the study express the distribution of power and prestige which is typical of hospitals. Many of the meanings people ascribe to their experiences within the organization are mediated by social representations originating in the broader social context to which the organization belongs.

Metodologia de elaboração do Índice de Percepções Organizacionais

This article presents the methodological basis for elaborating an Organizational Perceptions Index. The tool allows one to grasp the perceptions of organization members and solve some problems identified in the process. It is assumed that perceptions are the result of individual and collective subjectivities, the latter referring to culturally-bounded, socially-constructed representations. The Organizational Perceptions Index expresses the positive or negative perceptions of organization members and integrates data related to four organizational dimensions: infra-structure, management, environment, and culture. The methodology integrates research data in an evaluation tool, with the aim of orienting interventions and monitoring changes over time.

Procedimentos e percepções de profissionais e grupos atuantes em mercados de planos de saúde no Brasil

This study analyzes the mechanisms used in Brazil by health plan and insurance operators, hospitals and physicians for organizing the access to health care services and their strategies towards cost reduction and decision-making. The study is based on the literature about regulation of the health services, with special focus on micro-management and managed care. From an intentional sample of health care organizations selected according to the number of beneficiaries, organizational modality and geographic criteria we selected probabilistic samples of doctors and hospital services. Data were collected through questionnaires applied to key informants from health care operators and affiliated doctors and hospitals. Results suggest that the relationships between health care organizations, physicians and hospitals follow basically patterns inherited from the former social security system, mainly with fixed pricing and open account payments. More complex financing mechanisms, risk sharing and efficiency strategies are of minor interest. Mechanisms for risk reduction and encouragement of adequate use of technologies are weak. Cost control is mainly based on co-payment and barriers to access to the services. We conclude that in Brazil managed care is still in its beginning.