Implementação da política pública de Parceria Público - Privada na saúde: estudo de caso do Serviço de Apoio ao Diagnóstico por Imagem na Bahia

Abstract

This dissertation aimed to understand the process of implementing Public-Private Partnership (PPP) in Support Services for Diagnostic Imaging in the Public Health Network of the State of Bahia, considering the strategies, specificities and relationships between Principal-Agent. Qualitative research was carried out through a case study. Data were treated through content and document analysis. The theoretical basis was the Agency Theory, the New Public Management approach and the Public Policy cycle, specifically with regard to the Implementation stage. Some problems regarding the Agency Theory were discussed: opportunistic behavior; nature of uncertainty, since the contract that governs this relationship is long term; information asymmetry and difficulties in the management of Image PPP. The results indicated that the Diagnostic Support Service has specificities and that the process of implementing the PPP requires, from the Principal, strategies that involve capacity for governance, planning, monitoring and evaluation of services, training of personnel and investments in infrastructure, such as Information Systems, which have not yet been sufficiently developed. As for the Implementation methodology of this PPP, aspects of the top-down and bottom-up perspectives were verified. This dissertation sought to contribute, in theoretical and practical terms, to deepen the knowledge about the implementation of PPP in Diagnostic Support Services. That being said, it is recommended that the Principal adopt strategies capable of reducing the difficulties of the Implementation and invest in improvements in the monitoring and evaluation of the activities developed by the Agent, as explained in the Bidding Notice and in the Contract, in order to achieve the principle of efficiency and evaluate user satisfaction