A construção de um modelo de avaliação por profissionais e gestores de saúde: validação e consolidação de dimensões e indicadores de performance em serviços e unidades de saúde do SUS

Abstract

After 30 years of SUS, there is still no institutionalized and continuous national system of evaluation of results and performance in public health, although the Brazilian State has implemented structural actions in the area of New Public Management or Managerialism, which require managers to monitor results, control and accountability. Objective: We studied some relevant theoretical frameworks and proposals of dimensions and performance indicators in health services and units, aiming at constructing an innovative instrument based on the prior knowledge of a sample of specialists and managers in the SUS context. Methods: Collaborative panels with 220 managers and health professionals (in successive phases - panel of experts, Delphi groups and field research) were collected valuations of evaluated items in the SUS context. The results obtained from 108 specialists and 112 health managers were the object of descriptive and inferential analysis. Results: The performance evaluation items that emerged and had mean scores above level 3 (relevant), classified as subcategories (20 and 24 evaluation domains) and as categories (five and six evaluation domains), were used for inferential analysis, with methodological rigor. Reliability and validity analyses resulted in a final model of 17 domains (indicators) and four evaluation domains that validated a panel proxy for indicators and dimensions for SUS units.