O processo decisório no campo da saúde: levantamento e reflexão sobre a literatura brasileira (2016-2021)

Abstract

This study has as its theme the decision-making process in the field of health: survey and reflection on Brazilian literature (2016-2021). Its main objective is to understand the process of historical constitution of the field of health in Brazil and to analyze through the national literature produced between 2016 and August 2021, how the decision-making process in this environment has been investigated, tracing reflections and inferring about the content, approaches and perspectives expressed in the studies. Specifically, we sought to understand the process of historical constitution of the field of health in Brazil, presenting its main sectors and characteristics; Identify the current state of Brazilian productions aimed at understanding the decision-making process in the health field through the construction of a systematic literature review; Weave reflections on Brazilian literature based on the theoretical assumptions of the American psychologist Howard Rachlin and outline new thematic possibilities for research in order to contribute to the expansion of the field of decision-making in health. Its construction was guided by the following questions: Historically, how was the process of articulating the health field in Brazil? What is the current state of scientific production related to decision-making in the field of health? What reflections and inferences can be made in relation to the range of studies on health decisions produced in recent years? In addition to Howard Rachlin's theoretical assumptions, a range of studies related to health management were used. The bibliographic research and the Systematic Literature Review were used as a methodological apparatus. The organization of the text is divided into three articles. In the first one, a historical and structural contextualization of the health field in Brazil was carried out. In the second study, a Systematic Review of Brazilian Literature on the decision-making process in the health field was developed. Finally, the third study proposed to carry out a reflection on the 26 studies identified through the Literature Review carried out in the second article, based on the assumptions of Howard Rachlin. Through Rachlin's decision-making assumptions, it was possible to identify the influence of external agents on the decision-making structure portrayed in the works, which have specific contexts and approaches. The results obtained present a broad panorama of studies focused on health decision analysis. Among the main highlights, the implementation of technologies as support resources for decision-making and the analysis of different spaces and contexts in which this phenomenon occurs indicates a concern to diversify the field of analysis, previously focused especially on the internal environment of organizations. The results also show a need to invest in investigations of other aspects of the decision, such as the subjective structure of individuals, the hierarchy of the decision-making process, the phenomenon of medication errors, among other possibilities.