Estrutura de governança e cadeia de valor: comparação entre um hospital público e outro privado na cidade de Juiz de Fora/MG

Abstract

The research aimed to present a comparison between the value chain and governance structures between two hospitals, one public university hospital and the other a private hospital, both located in the city of Juiz de Fora/Minas Gerais. It was tried to show a theoretical reference on the value chain, as well as on the studies of corporate and public governance, from the perspective of Oliver Williamson and the Brazilian Institute of Corporate Governance. In addition, it was discussed how the administration of services, the health sector in Brazil, in its public and private contexts, and a positioning of health organizations in the value chain. As for the methodology adopted for the research, it was a qualitative study in which data collection was used for documentary research, semi-structured questionnaires and personal interviews with 10 hospital representatives, 6 managers and 4 directors. After the discussion and analysis of the data, it was observed that the University Hospital of the Federal University of Juiz de Fora has no end-of-activity outsourcing. By an evaluation of governance, it can be said that its structure is hierarchical, with small traces made through the market or in a hybrid way, and its primary activities of the value chain are carried out internally. On the other hand, in the results of the material collected at Monte Sinai Hospital it is possible to observe a high rate of outsourcing, and it is possible to affirm that its governance is predominantly market, that is, most of its primary activities are being sought in the market. At the outset, there are threats, such as a decrease in quality, an increase in the cost of services and a possible loss of control, which can affect the governance structure in the case of the private hospital, a characteristic that was not found in the public hospital .