Repasses ao terceiro setor na área da saúdea crescente opção administrativa pela terceirização e seus impactos nos indicadores de desempenho dos municípios paulistas

Resumo

This paper addresses the increasing involvement of the Third Sector in the execution of public health policies in the municipalities of São Paulo state under the jurisdiction of the State Court of Accounts of São Paulo during the period from 2019 to 2023. It evaluates the potential impacts of discretionary decisions made by municipal managers on performance indicators in such an essential area for the community. Through the lens of the State Managerial Reform of 1995 and the organizational formats implemented from the new public contractualism, which involves the sharing of responsibilities through consensual arrangements aimed at achieving the common good, the research examines the normative changes that have characterized the remarkable expansion of the relationships between the State and Third Sector entities, as well as the roles played by External Control Bodies in contributing to the efficiency and effectiveness of governmental transfers. Using case study methodology, the municipalities were grouped according to their population size to observe the dynamics of the evolution of the degree of outsourcing and the subsequent assessment of the effects generated on the corresponding health performance indicators. The results revealed that choices to increase transfers to the Third Sector or to maintain high levels of outsourcing proved beneficial in some of the evaluated parameters, depending on the grouping of municipalities analyzed. The research concludes that, in light of the new governance model proposed in managerial administration, set within a multifaceted and plural reality, the various actors involved must work together to overcome existing challenges in order to achieve the social objectives established in the Federal Constitution of 1988.

Ficha do documento

Tipo

Dissertação

Ano

2025

Instituição

Fundação Getulio Vargas

Fonte

Repositório da FGV

Idioma

Português

Acesso

Acesso aberto

Identificador

oai:repositorio.fgv.br:10438/37027

Temas

Administração PúblicaDadosGovernançaSaúdeGestão Municipal

Palavras-chave

Reforma gerencialTerceiro setorServiços de saúdeControle externoAvaliação de resultadosManagerial reformThird sectorHealth servicesExternal controlResults evaluationAdministração públicaAssociações sem fins lucrativos - São Paulo (Estado)Reforma administrativaServiços de saúde - TerceirizaçãoDescentralização na administração