Avaliação em saúde pública no Brasil a partir da teoria institucional: o caso do Índice de Desempenho do Sistema Único de Saúde (IDSUS)

Abstract

The general objective of this work is to discuss the trajectory and conditioning factors of the construction and implementation of IDSUS from the historical perspective of the NeoInstitutional Theory through the Path Dependency. The work is based on the qualitative, documentary-based approach, using the Historical Narrative applied to Path Dependence. The aim was to present the institutional development of the Unified Health System and its evaluation policy, focusing on the definition and implementation of the IDSUS, based on the analysis of the actors' actions, limited to the national health conferences, understood as the main arenas of discussion. The Unified Health System is presented as a result of the institutional (re) construction process that took place in the national health conferences, as well as the evaluation policy of public health actions and services are understood as arising from the (still incipient) discussion in the arenas negotiations on this matter. It is understood that IDSUS, currently confined to a sort of managerial limbo, has not been able to establish itself as an instrument for improving the public policy process, since it has not been able to garner support from important actors such as political agents, health experts The general population,after the initial impact of the publication of the results. As methodological restrictions, it is worth mentioning the difficulty in obtaining from the Ministry of Health more detailed data and information regarding the process of definition and construction of IDSUS, except for those already available in official communication channels