title: [An analysis of managed care provided by charitable hospitals in Brazil].
abstract: This article describes charitable hospitals in Brazil that provide managed care and the health management organizations themselves, considering the level of autonomy by the latter in relation to the hospitals and their degree of management development, based on a nationwide study. A random sample of individual hospitals was drawn from the hospital groups. After refusals and replacements, the final sample consisted of 112 individual hospitals and 10 hospital groups. The charitable hospitals' managed care plans do no operate precisely according to the overall Brazilian health plan market, in which most of the managed care is situated in insurance companies, group medicine, and medical cooperatives. Rather than operating as typical plans, they function "inside the organization or hospital itself", almost always with a limited management infrastructure and with little autonomy in relation to the organizations harboring them. Individual plans were more common than collective products, unlike the rest of the market, which may also result from the limited management capacity of these arrangements.
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. domingue@ensp.fiocruz.br
authors.forename: Maria Alicia D
authors.initials: MA
authors.lastname: Ugá
authors.forename: Sheyla Maria Lemos
authors.initials: SM
authors.lastname: Lima
authors.forename: Margareth Crisóstomo
authors.initials: MC
authors.lastname: Portela
authors.forename: Miguel Murat
authors.initials: MM
authors.lastname: Vasconcellos
authors.forename: Pedro Ribeiro
authors.initials: PR
authors.lastname: Barbosa
authors.forename: Silvia
authors.initials: S
authors.lastname: Gerschman
mesh_terms: D001938:Brazil; D002608:Charities; D003695:Delivery of Health Care; D003710:Demography; D006279:Health Maintenance Organizations / Q000191:economics / Q000458:organization & administration*; D006788:Hospitals, Voluntary / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health / Q000592:standards; D017061:Prepaid Health Plans / Q000191:economics / Q000458:organization & administration*