Ciência & Saúde Coletiva
On-line version ISSN 1678-4561Print version ISSN 1413-8123
COSTA, Nilson do Rosário; RIBEIRO, José Mendes and SILVA, Pedro Luís Barros. State reform and organizational change: a study of public hospitals. Ciênc. saúde coletiva [online]. 2000, vol.5, n.2, pp.427-442. ISSN 1678-4561. http://dx.doi.org/10.1590/S1413-81232000000200015.
The paper analyses the process of diffusion of the state reform agenda in the social area, taking case studies from the health sector. It presents the processes by which public policy is formed and strategies established for bringing greater flexibility to administration. In each institution selected, identifies development trends, indicating the bottlenecks and potential of each model, as well as the scope for replication. It emphasizes the health sector reform from the point of view of organizational design, reconstructing the relevant institutional engineering related to forms of administrative flexibility. To reconstruct the arrangements for more flexible labor management, describes patterns of organization, selection criteria, forms of planning, evaluation and oversight criteria of effectiveness by type of care, and forecasts of impact on access and utilization.
Keywords : State Reform; Public Organization; Health Sector; Public Hospitals; Administrative Innovation.