University hospital and health system management: a positive integration trajectory

uma trajetória positiva de integração

Abstract

In Brazil, University Hospitals have had different forms of participation within the health system. Since the 1980´s they have become more relevant with the reduction of services provided by the philanthropic and private hospitals to the public health system. This work intends to describe and analyze how the University Hospital (Hospital das Clinicas) of the Federal University of Minas Gerais (HC-UFMG) joined the health system of the city of Belo Horizonte, in the period between 1996 and 2004, within the national context of both the National Public Health System (SUS, in Brazil) and the policies introduced to the UH. Bibliographical and documental research was carried out to learn more about the relationship of the UH with the health system throughout the years, as well as the specificities of the relationship between the UH and the health system. Through semi-structured interviews, we have identified factors that can either help or hinder integration in the eyes of the actors involved in the process. Despite the conflicts created by the confronting of powers and practices instituted in the UH, besides the new municipal management challenge brought by the management of a University andTeaching Hospital, the experience has been positive. There has been an enlargement and more service user's access equity, helping to reduce the difficulties of the health system. The teaching activities have been enlarged, and there have also been financial and organizational gains. Over a decade after its implementation, it is useful in the discussion about new and urgent changes in the UH sustainability and organizational structure of the UH within the Brazilian health system.