Auditoria operacional aplicada a sistemas municipais de saúde: um estudo a partir da experiência do Tribunal de Contas do Estado do Rio de Janeiro

• Ano de defesa: 2008
• Autor(a) principal: Nóbrega, Sérgio Wilson Sefer
• Orientador(a): Teixeira, Sônia Maria Fleury
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Sistema Municipal de Saúde; Controle externo; Tribunal de contas; Auditoria Operacional; SUS; Regulação; Controle e avaliação; AOSMS
• Palavras-chave em Inglês: Municipal Health System; External control; Audit court; Operational audit; Regulation; Control; Evaluation
• Link de acesso: http://hdl.handle.net/10438/3602

This research aimed at evaluating the efficiency of a specific model of operational auditing, created to audit municipal health systems, which are part of the Sistema Único de Saúde in the State of Rio de Janeiro, the AOSMS. Thus, it attempted to find out whether they represent a valid method of auditing the performance of SUS in the State of Rio de Janeiro based on the isolated or combined utilization of efficiency and efficacy criteria, and to finalize, how the AOSMS may contribute to the improvement of the municipal management of SUS. The study is based on two references axes, as follows: criteria and paradigms of operational auditing according to what International Organization of Supreme Audit Institutions (INTOSAI) understands about this methodology and the evaluation method of health services proposed by Avedis Donabedian, based on the triad structure, process and result. The work consisted initially in verifying compatibility and evaluating potential of the parameters that constitute the AOSMS with the adopted references, in the light of the basic principles that inform the Brazilian Sistema Único de Saúde and afterwards in the submission of these parameters to the analytic categories created in this study with the intent of checking its adequacy and pertinacity to analyze public health systems. In order to reach its objective the research used the case study strategy of the TCE-RJ experience of holding operational audit in 39 municipal health systems in the State of Rio de Janeiro developed between 2000 and 2007. The result confirmed the hypothesis of the study and revealed how the AOSMS, considered as a valid methodology for its finality, may contribute for the improvement of the municipal management of SUS, reaffirming the potential of operational auditing to proceed with the evaluation of the performance of the Sistema Único de Saúde in the angle of external control, considering however that its application in Brazil, because of the external control model constitutionally adopted, must pass through due sociological reduction.