title: The process of defining the hospital care profile in federal hospitals in the city of Rio de Janeiro, Brazil.
abstract: This article analyzes the process of shaping the care profile of federal hospitals in the city of Rio de Janeiro. This is a qualitative, descriptive study that draws on semi-structured interviews with hospital administrators. Data analysis used the Collective Subject Discourse approach. Managers believe this process is the result of a set of emerging strategies, proposals and need for change, which result in adaptive reactions that hospitals develop with no coordination between them to resolve problems identified by professionals and managers. The process is analyzed much more from a political point of view than from a rational and systemic one. Some of the experience with the hospital mission, such as the focus on a strategic approach, already signals a more collegiate approach to defining the profile of care, where the hospital is one component of an integrated network of services, with a decision process that is less incremental and more integrating.
authors.affiliation: Instituto Nacional de Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil. lucianebinsfeld@gmail.com.
authors.forename: Luciane
authors.initials: L
authors.lastname: Binsfeld
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz. Rio de Janeiro RJ Brasil.
authors.forename: Francisco Javier Uribe
authors.initials: FJ
authors.lastname: Rivera
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz. Rio de Janeiro RJ Brasil.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Artmann
mesh_terms: D001938:Brazil; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006739:Hospital Administration / Q000379:methods*; D006740:Hospital Administrators / Q000706:statistics & numerical data*; D006768:Hospitals, Federal / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D014481:United States