Fabiana Turino, Jonathan Filippon, Francis Sodré, Carlos Eduardo Siqueira
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引用次数: 3
摘要
在新公共管理(NPM)的影响下,巴西的国家机器在整个20世纪90年代进行了改革。国家预防机制通过建立社会卫生组织(Organizações Sociais de Saúde或OSS)体现在保健部门,这些组织是提供福利服务的私营非营利实体。我们对文献进行了系统的回顾,概述了OSS在巴西的起源和作用。我们精选的文章(同行评审)涵盖了1998年至2018年间OSS的起源/性能及其服务提供,英文或葡萄牙语。使用的数据库有Lilacs、Bireme、Medline、Pubmed和SciELO。我们使用一组预定义的描述符识别了4,732篇文章,从中选择了49篇进行分析。主要发现表明,NPM是巴西大多数关于OSS的文章的中心主题(n = 26)。有证据证实了我们的假设,即将公共卫生保健服务的管理转移到私人非营利组织是私有化的一种软版本,因为尽管融资是公开的,开放源码软件服务的基本原理和精神在制度和运作上模仿了私营部门。其实际后果是,在巴西获得保健服务最终既没有完全商品化(以支付能力为基础),也没有按照国家宪法作为一项公民权利实现。
Reinventing Privatization: A Political Economic Analysis of the Social Health Organizations in Brazil.
The Brazilian state apparatus was reformed throughout the 1990s, influenced by New Public Management (NPM). NPM was embodied in the health care sector by the creation of Social Health Organizations (Organizações Sociais de Saúde or OSS), private non-profit entities to provide welfare services. We performed a systematic review of the literature outlining the origins and role of OSS in Brazil. Our selected articles (peer-reviewed) cover the origins/performance of OSS and their services provision between 1998 and 2018, in English or Portuguese. Databases used were Lilacs, Bireme, Medline, Pubmed, and SciELO. We identified 4,732 articles applying a pre-defined set of descriptors, from which we selected 49 for analysis. The main findings reveal that NPM is the central theme of most articles about OSS in Brazil (n = 26). There is evidence corroborating our hypothesis that transferring management of public health care services to private non-profit organizations is a softer version of privatization as, although financing is kept public, the rationale and ethos of OSS services institutionally and operationally mimic the private sector. The practical consequence is that attainment of health care in Brazil ends up being neither fully commodified (based on ability to pay) nor fulfilled as a citizen's right following its national constitution.
期刊介绍:
The International Journal of Health Services is a peer-reviewed journal that contains articles on health and social policy, political economy and sociology, history and philosophy, ethics and law in the areas of health and well-being. This journal is a member of the Committee on Publication Ethics (COPE).