Repercussões das terceirizações médicas na percepção dos gestores e médicos da Secretaria Estadual de Saúde do Maranhão.

Abstract

The study aims to analyze the effects produced by medical outsourcing in the management of work in the Maranhão Department of Health (SES/MA). A qualitative and exploratory case study was carried out on the hiring of outsourced physicians, taking into account the work management guidelines and health education. Data production involved bibliographic research, document analysis and semi-structured interviews with key informants by intentional sampling, based on a previously established script. The study population consisted of actors involved in the hiring process of outsourced managers and physicians. Document research involved six types of documents related to contracting via outsourcing. Interviews with managers and physicians were analyzed using the following analytical categories: a) facilities and advantages of outsourcing b) difficulties and disadvantages of outsourcing. The results highlight that the SES/MA has a diversity of employment relationships and that the number of active physicians has not corresponded to the needs of the state health system, which contributes to the advancement of outsourcing. In this sense, the State has used outsourcing to hire human resources and management of health units, through management contracts. The perceptions of managers regarding the advantages of outsourcing would be in the gain in quality and greater productivity, more agility and competitiveness. For the interviewed physicians, outsourcing was not evaluated as a disadvantage, but as an advantage, in terms of remuneration and working conditions.