Recursos humanos em hospitais do Sistema Único de Saúde: entre a assistência e a gestão

Abstract

This study aims to investigate the capacity of policies and practices of Human Resources developed in SUS´ hospitals to provide support do care activities, thus contributing the overall performance of the health system. Moreover, attempts to trace a possible difference between the structured human resourses practices and policies in hospitals of different juridical nature. For this, the study was based on a theorical framework structured around two axes: the National Health System and Human Resource Management for Health. From the literature review, it was possible to establish essential categories of analysis for the study, grouped into eight dimensions: entry; performance job; performance systems support; performance enabling environment; exits; perception of human resourses managers; perception of assistance managers and forms of employment in the hospital. Data collection occurred in four hospitals. Eight human resourses professionals and seven assistant managers were interviewed. Data collection was completed with observations and institutional documents. Data analysis was performed in two stages, at first the hospitals were analyzed individually and in second stage compared with others, based on the rules of management (on public and private rules). The results showed five main points: a) there is a gap in framing policies and HR practices in hospitals that contribute to the effectiveness of care; b) the structuring of policies and practices of human resources in institutions is in fact closely linked to the way staff is hired; c) the public selection process is unable to provide personnel as fast and with the quality needed; d) the setting and motivation of staff are influenced by the way that they are hired; e) there is more autonomy for managing staff in hospitals run by the rules of private law.