Sistemas de Avaliação Profissional no âmbito da Contratualização da Gestão na Atenção Primária à Saúde

Abstract

This thesis research aims at studying the process of performance evaluation and contracting management for health professionals within the context of primary care reform. It was performed a case study in Portugal to know the trajectory of primary care reform, studying its organizational model and management as well as the methodologies for performance evaluation and professional contracting. This study allowed the analysis of the processes that have been established for primary care in Brazil as the national program to improve access and quality in primary care (PMAQ-AB). The objectives of the study were to analyze the general context and constraints of the conditionalities system deployment job evaluation in APS, identify facilitating factors and limiting management process, identify the monitoring tools and the perception of managers on the process. This is an exploratory, descriptive narrative research, literature and documents, with a qualitative approach. Data collection consisted of a literature review, analysis of official documents and interviews with managers, coordinators of Family Health Units, council representatives and clinical unit management support in Clusters of Health Centers (ACES). As a result, the work points to a new coordination structure of health facilities with the decentralization of services, requiring greater autonomy on the part of managers and professionals, with a focus on strategic planning, combined with the strengthening of the management capacity of leaders and regulation of an evaluation system, has contributed to strengthening the management in Primary Health Care. Points as triggering factors of success when analyzing a system of professional evaluation, as the case of Portugal, the reduction in public spending, management by objectives, the introduction of clinical governance, teamwork, greater accountability of professionals and professional advancement, as a set of recommendations that would benefit the progress of reform and improvement PMAQ in Brazil, also considering its initial phase.