Impact of Social Health Organizations' Management in Hospitals on Mortality Indicators
Social Health Organizations; Public Administration; New Public Management; Differences-in-Differences.
This work consists of an impact assessment of the adoption of the management model by Social Health Organizations (OSS) in hospital units. This management model, advocated by Law No. 9.637/98, was conceived as a reflection of the rise of New Public Management and presents itself as an alternative to state rigidity regarding the provision of public policies, seeking greater efficiency. An econometric model of Differences-in-Differences with two-way fixed-effects at the level of the hospital unit and year was developed, aiming to estimate the effect of OSS management implementation on health indicators, more specifically on the mortality rate and the mortality rate due to Primary Care Sensitive Conditions. The estimated results indicate that OSS management significantly contributed to the reduction of the mortality rate for Primary Care Sensitive Conditions, both in the model without control variables and in the model with these variables. This result corroborates the hypothesis that OSS management is more efficient in managerial aspects that are reflected in health indicators, in which this main diagnostic group indicates diseases that are susceptible to clinical recovery when various procedures within Primary Care are followed, such as preventive measures, correct diagnosis, and appropriate treatment. Thus, the study constitutes a contribution to the impacts of this management model, supporting the hypothesis that the State, by ceasing to be a direct provider of public policies and assuming a role as a regulator, can achieve more efficient results in the provision of public policies.