Mixed-method assessment of quality of care and management in a public teaching hospital in the state of São Paulo

Abstract

The hospital contracting model in the SUS began in 2004, with the Teaching Hospitals Restructuring Program. This study evaluated the quality of care and management of a teaching hospital, under the management agreement modality, with the São Paulo State Health Department. It is a single case study, with a mixed research methods approach using indicators of care and management quality (access, effectiveness and efficiency) and interviews with members of the agreement evaluation committees. Inferential statistics were used through the Interrupted Time Series analysis technique for quantitative data and content analysis for qualitative data, comparing them after the implementation of the new model, through the fusion for integration method. Of the nine quantitative indicators, seven showed an improvement trend, two at a significance level; two showed a worsening trend, one at a significance level. The qualitative data showed an improvement in management effectiveness, without any improvement in the other sub-dimensions. The integrated analysis of the data suggests that the implementation of the management agreement modality with SES-SP did not bring significant changes in the quality of health care or hospital management.