Avaliação do desempenho das operadoras de planos de saúde com certificado de acreditação

Abstract

Introduction: Accreditation is a process for evaluating institutions to verify compliance with quality standards. Studies that prove the impacts of this process are scarce. Objective: To analyze the relationship between the accreditation of health operators and the present performance in relation to the quality assessed by the National Supplementary Health Agency (ANS), in the Operator Qualification Program. Method: Observational study carried out with 636 operators evaluated in the Operator Qualification Program (base year 2018). Data collection was carried out through public reports made available on the ANS website. For data analysis, the profile of accredited operators was drawn up; the Student T test was applied to evaluate the operators' performance in the Operator Qualification Program and the Mann-Whitney test to assess whether the performance was increasing among the accredited operators, according to the classification level (Levels I, II and III) . Results: The accredited operators (n = 53) comprised 8.3% of the active operators; 89% were classified in Level I and 9% in Level II and only one, in Level III (2%). The accredited operators obtained an average of 0.7959 and the non-accredited operators of 0.6118 (p value 0.00) in the Operator Qualification Program. The operators' performance was not increasing according to the level of accreditation classification. Conclusions: The tests carried out proved that the accredited operators performed better than those not accredited in the Operator Qualification Program. The indicator related to the management of access to services presented the worst performance of the operators. The results of this work can be used as an incentive to the accreditation and implementation of improvement processes.