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Ciência & Saúde Coletiva

Print version ISSN 1413-8123

Abstract

PAIM, Chennyfer da Rosa Paino  and  ZUCCHI, Paola. Evaluation auditing of the quality of health care in accreditation of health facilities. Ciênc. saúde coletiva [online]. 2011, vol.16, suppl.1, pp. 1163-1171. ISSN 1413-8123.  http://dx.doi.org/10.1590/S1413-81232011000700048.

This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88,88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.

Keywords : Health services evaluation; Accreditation of health facilities; Quality of health care.

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