Development of evaluation methodology of coordination in metropolitan healthcare networks

Abstract

A great part of policies, explicitly or implicitly, involves shared responsibilities among different organizations; such as departments, governmental spheres, ministries or private organizations. This fact makes policy implementation a fragmented process and evidences the needs of coordination in the programs' daily practice. The health care system in Brazil is an example that demonstrates the complexity and fragmentation in the implementation process. In the middle of this health systems' fragmentation, the concept of Healthcare Networks emerges and consolidates. Therefore, coordination is an essential part of healthcare networks. Another characteristic of healthcare networks is their regionalization process, as it becomes necessary to go beyond the municipal boundaries for resource optimization in healthcare. This scenario of inter-regional relations gains greater density when this territorial dimension is configured in an urban superstructure, as it is in the case of metropolitan areas. In this sense, a deeper analysis of the forms of coordination and governance of Healthcare Networks in metropolitan scale becomes very fruitful. Although the literature recognizes the importance of coordination in the management process of the healthcare networks, a methodological framework for the analysis of coordination has not been developed yet. Thus, this project proposes the development of a methodology for evaluating the coordination of healthcare networks in metropolitan areas. As a result, this research will produce a consistent methodological framework for the analysis of coordination in Metropolitan Healthcare Networks. This framework will enlighten, firstly, the elements involving the problem of coordinating in the metropolitan networks and, secondly, may be used as a guide to assist administrators in identifying problems in the various Healthcare Networks. (AU)