Hospitais universitários e integração ao Sistema Único de Saúde -estudo de caso: Hospital das Clínicas da UFMG-1996 a 2004

Abstract

The education hospitals exist in Brazil since the arrival of the royal family in Brazil, on 1808, having great expansion from the 1970s, following also the expa nsion of medical education. From hospitals destined essentially to education and research, they had started to have greater assistencial importance for the health system, in the measure where it had the rendering of services retraction for the philanthropi c and private sector, after the bankruptcy of the privatist medical assistential system, in the decade of 1980. The health services decentralization, the financial crisis lived deeply by the entailed MEC hospitals, due to the not replacement of the work force, and the establishment of these hospitals reorganization politics , commanded for the Health department, had taken to the movement of bigger approach and integration of these hospitals to the local and state systems of health. The internal relations es tablished power, the logic of the assistance organization based on education and the change of the forms of hospitals financing, on the other hand; and the managers position differences in relation to these hospitals, not recognizing its characteristics, o n the other hand, have generateddifficulties in the relations, with institucional damages for the diverse actors who act in this scene. This study had the objective to describe the integration experience between the Hospital of the Clinics of the UFMG and the City department of Health of Belo Horizonte, in the period of 1996 to 2004. Documentary and bibliographical research and interviews with the municipal manager of the SUS, the hospital general director and with the chairman of the board of Health of the hospital had been carried through. One evidenced that, despite the conflicts generated from the confrontation of power and practices instituted in the hospital, and municipal management segments resistences in the understanding and conduction of the process, the experience has been positive. It was observed that it had magnified and increased the users access equity to the hospital services, contributing for the system strangulations reduction ; bigger possibilities of education activities with the magni fying offer services and organizacional and financial profits by the part of the hospital. The study points challenges and ways with respect to the integration perfectioning.