GESTÃO DOS PLANOS DE SAÚDE NA MODALIDADE DE AUTOGESTÃO: ESTUDO DE CASO DE UMA AUTARQUIA FEDERAL

Abstract

The objective of this research was to analyze the health plan of a federal autarky, facing some dimensions of management characteristic of the self-management modality, such as participative management, flexibility, provider network, cost and programs for disease prevention and servers health promotion. The focus was in the self-management modality for being the one that enables better communication between managers and beneficiaries, more efficient assistance to beneficiaries needs, at a compatible cost, and especially for ensuring the participation of beneficiaries in managing their own health plan. For this, we attempted to identify and analyze the management structure of the plan on these dimensions, by evaluating the answers given in a questionnaire prepared for this purpose applied to a sample of active and retired beneficiaries of the Medical Plan of Rio de Janeiro. With the results obtained from this evaluation it was possible to raise the positive and negative points of self-management modality, and it also allowed evaluating the medical plan of the National Nuclear Energy Commission and suggesting improvement measures.