The crisis of university hospitals in Brazil

In Brazil, there are 148 teaching hospitals. Of these, 45 are University Hospitals, tied to Federal Universities. Teaching hospitals are highly complex organizations, since they serve as field of practice for curricular activities and research in health sciences, besides providing health care to the community. The study aimed to provide a critical assessment about the current situation of teaching hospitals in Brazil, from the case study of the University Hospital of Brasília. The method of Participatory Strategic Planning was selected, involving three steps: situational analysis, design, and management of the Institutional Development Plan. For the situational analysis, two workshops were conducted with representatives of management, faculty, clinical staff and students. Five topics synthesize the determinants involved in the generation of the problems: a history of crisis and conflicts; the sustainability of financing and costs; the hospital mission, its roles on health assistance, and the challenge of its integration to the healthcare network; the organization of health assistance, teaching and research; and management challenges. The situational analysis provided the initial diagnosis that will guide the formulation of the Institutional Development Plan. This plan will face the identified problems. The HUB has historical, technical and managerial abilities to reconstruct its institutional identity, reinforcing the partnership between academia and healthcare practice.