Abstract

SOUZA, Josiane Teresinha Ribeiro de. Managerial Handcuffs: Analysis of access assessment and improvement of health quality in Brazil. Psicol. Conoc. Soc. [online]. 2022, vol.12, n.3, pp.60-94.  Epub Nov 30, 2022. ISSN 1688-7026.  https://doi.org/10.26864/pcs.v12.n3.4.

This paper questions the evaluative process of the National Program for Improving Access and Quality of Primary Care in Primary Health Care in Brazil, based on the performative character of this instrument in the world scenario of increasing management of health policies. Objective: To understand how the quality of access is defined in practical terms and what actions are promoted to Primary Health Care workers through Ordinance 1,645 and the Evaluation Instrument applied to Extended Centers for Family Health and Primary Care professionals. Methods: A Pragmatic Discourse Analysis was performed, with the help of Atlas.ti 8 and Microsoft Excel 2010 Software. Results: The results reveal standards and indicators promoted by the National Program for Improving Access and Quality of Primary Care, as well as the ambivalent role of managers and health professionals, between their voluntary and proactive character and reveal the dismantling of the Primary Health Care model under community logic in Brazil, compared to the New Public Management approach and the performance in function of indicators. Conclusions: The role of the State in guaranteeing the right to health is minimized and gives way to New Public Management in healthcare.

Keywords : Primary health care; new public management; performance evaluation.

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