Public-Private Partnership in healthcare: the experience of Latin America's largest public emergency room.

Brazilian scientific production on the subject of Public-Private Partnerships (PPP) in health is still scarce. In the state of Rio de Janeiro, the first PPP initiative was launched in 2023 for the Souza Aguiar Municipal Hospital Complex (Complexo Hospitalar Municipal Souza Aguiar - CHMSA) involving three SUS units in the capital: a maternity hospital, a general emergency hospital operating 24/7, and a regional emergency center (Centro de Emergência Regional - CER). We sought to characterize the unit, analyze the decision-making processes of the PPP implemented in this Complex, based on the experience of its key players during its formulation, implementation, and follow-up. Our study also highlighted the fundamental role of the permanent health education (Educação Permanente em Saúde - EPS) process, which was key to sustaining the change in the adopted management model. The results show that after the first year of the PPP's implementation, several adjustments have been necessary to make it possible to measure the indicators agreed upon with the concessionaire. By contrast, the Souza Aguiar OTICS Station has stood out as a major training center for Rio de Janeiro's SUS, with more than 2,500 workers trained in its first year of implementation by the SMS-RJ.