title: [Clinical guidelines and other practices for improving quality of care by health plans from the perspective of their operators in Brazil].
abstract: This study aimed to characterize the implementation of clinical guidelines and other instruments and practices for health care quality improvement among health plan operators in Brazil. It was a national cross-sectional descriptive study, initially considering 1,573 health plan operators registered in the National Agency for Supplementary Health Care. The sample design was complex, stratified by macro-region, market segment, and number of beneficiaries. Ninety health plan operators agreed to participate and were interviewed. To obtain estimates for the universe of health plan operators, a sample expansion factor attributed per stratum was considered. Only 32.3% of the health plan operators implemented clinical guidelines, with important variation across regions and market segments. Clinical governance practices are still in the very initial stages. Challenges are presented with regard to health care incorporation as a dimension of management within health care organizations, including health plan operators. Initiatives to improve quality of care need to be integrated and conducted at the organizational level.
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. mportela@ensp.fiocruz.br
authors.forename: Margareth Crisóstomo
authors.initials: MC
authors.lastname: Portela
authors.forename: Sheyla Maria Lemos
authors.initials: SM
authors.lastname: Lima
authors.forename: Vanja Maria Bessa
authors.initials: VM
authors.lastname: Ferreira
authors.forename: Claudia Caminha
authors.initials: CC
authors.lastname: Escosteguy
authors.forename: Cláudia
authors.initials: C
authors.lastname: Brito
authors.forename: Maurício Teixeira Leite de
authors.initials: MT
authors.lastname: Vasconcellos
mesh_terms: D001938:Brazil; D003430:Cross-Sectional Studies; D017408:Guidelines as Topic; D006801:Humans; D007407:Interviews as Topic; D017061:Prepaid Health Plans / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards