Auditoria odontológica em planos de saúde: a influência de um método padronizado de avaliação

• Ano de defesa: 2008
• Autor(a) principal: Noronha, Fernando de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Programa de Pós-graduação em Sistemas de Gestão; Segurança do Trabalho, Meio-ambiente, Gestão pela Qualidade Total
• Palavras-chave em Português: Auditoria odontológica; Regulação; Sistema de Saúde Suplementar; Ferramentas da Qualidade; Odontological Auditory; Regulation; Supplementary Health Care System; Quality Tools; CNPQ::ENGENHARIAS::ENGENHARIA DE PRODUCAO
• Link de acesso: https://app.uff.br/riuff/handle/1/21341

Nowadays, regulation is the rule of health care plan operators. This new rule emerged in terms of the current moment, where all sort of situations occurs and makes difficult not only the company life but users and professionals that are involved at the installment of health care service. Is mentioned as the origin of this situation the aggravation of the crisis at the public health service since the 80 s, expand to the fast development of insurance and private health care plan market in Brazil. The valid model of supplant odontological assistance, is supported in the installment service to patients, whether in private clinic or in credence professional surgery, being intermediate by the health care plan operator. In Brazil, the odontologic auditor is engaged or credence by the health care plans, mostly to supervise meaning as police , leaving in second place the quality assessment of the render service to beneficiaries by credence dentists. This new reality at the context of national odontology brought some problems, that, emphasize the conflicts among not only health care plan auditors but dentists and a rise number of complaint to the competent organ. The propose of this work study is to show the odontological segment in front of supplementary health care system, emphasize the difficulties of process and the necessary attribute of the auditor for a good fulfillment at regulation mechanisms. Thus, were selected, quality concepts and tools that are relevant to the odontological auditory area, reporting an implementation case of a standardize model to assess the services of a credence dentists network from a itself conduct health care plan. At least, is expected that the model studied can attend as a reference for future works, at odontology area and related areas that are involved