Análise da capacidade de gestão de empreendimentos de pequeno porte na área de saúde bucal no Brasil: contribuições da teoria da administração política

Abstract

In Brazil, although health is constitutionally guaranteed to every citizen, the incipience and inequality of the implementation of these public policies in the country and their underfunding, indicate that the provision of these services to the population has occurred, in large part, through the offer made by enterprises private. In this context, it is argued in this thesis that the businesses that offer assistance to oral health constitute instruments that integrate the national health policy. Based on this premise, this study assumes as a central assumption that there is a political and social nature in the management of these private services that reflects the complex dynamics that sustain and guide the social relations of production, consumption/circulation and distribution, as defended by the theory of Administration Policy. This allows recognizing that the analysis of the management of these organizations is not limited only to the interests of health professionals and the productive chain that integrates this segment, but permeates the general interests of the whole society. It is argued that this topic-object requires a critical and view of the field of scientific studies of administration, thus bringing a theoretical empirical innovation required for a doctoral thesis. This choice made it possible, therefore, to expand the managerial or instrumental perspectives that have guided, predominantly, administrative and organizational studies based on economic and scientific management approaches. The use of this critical epistemic and theoretical-empirical framework presents another relevant innovation regarding the design of an analytical matrix that privileged to articulate in an inseparable way the theoretical-abstract and technical-operational dimensions that qualify 'administrative facts and acts' of any nature. The results obtained in the field research confirmed, firstly, that the challenges in the management of private oral health enterprises produce negative impacts on the population's access to oral health policies in Brazil, thus making it difficult to achieve well-being. Social. And, secondly, they indicate a tendency towards precariousness in the work relations of these professionals who, because they are unaware of the relationship between 'thinking and executing' - managing and managing - their businesses, make little progress in acquiring skills, both to fulfill the functions social services that these public services require, such as ensuring the sustainability of enterprises.