Production
https://prod.org.br/doi/10.1590/S0103-65132011005000015?lang=en
Production
Article

Integração vertical nas operadoras de assistência médica privada: um estudo exploratório na região de São Paulo

Vertical integration in service industries: an exploratory study at the healthcare industry in São Paulo

Albuquerque, Gustavo M. de; Fleury, Maria Tereza L.; Fleury, André Leme

Downloads: 0
Views: 802

Resumo

Arranjos produtivos têm sido feitos em diferentes setores da economia, resultando em ciclos de integração quando uma empresa torna-se responsável por etapas consecutivas da cadeia de produção de bens e serviços. Esse processo, denominado integração vertical, apresenta implicações diversas, exploradas em estudos sobre operações industriais, economia dos custos de transação, competitividade e políticas antitruste. Este estudo tem como foco o setor de saúde e objetiva levantar a percepção de gestores do setor de assistência médica privada sobre esse movimento de integração vertical, suas motivações e implicações. Através de pesquisa qualitativa realizada com gestores de empresas de saúde sobre os possíveis benefícios da verticalização, observou-se que o controle dos custos de produção e a melhoria da qualidade ou resolutividade dos serviços médicos são os principais benefícios obtidos com esse processo. Os resultados corroboram em parte os de pesquisas realizadas no contexto norte-americano, porém também identificam dimensões diferentes, características do cenário analisado.

Palavras-chave

Indústria de serviços. Saúde suplementar. Cadeia produtiva. Integração vertical.

Abstract

Different production arrangements have been experienced in several economic fields. It is possible to observe integration cycles, when a company becomes responsible for consecutive stages in the production chain of goods and services. This process, known as vertical integration, generates many implications that have been analyzed by studies about operational management, transaction costs economics, competition and anti-trust regulation. Focused on the healthcare industry, this research aims to analyze the managerial perception about vertical integration in this field, aiming to gain insights about the motivations and implications of this process, not sufficiently exploited by the specialized literature. Using a qualitative approach, interviewees were asked to rank possible vertical integration benefits. It was noticed that the control of production costs and the optimization of services’ quality were the main benefits of this process. Obtained results reinforce some perceptions gained at studies conducted among north‑american companies; however, some differences were observed, which are characteristic of the analyzed context.

Keywords

Services industry. Private healthcare. Production chain. Vertical integration.

References



ABRAMGE. Dados e estatísticas da medicina de grupo. São Paulo, 2005. Informe de agosto.

ARGYRES, N. Evidence on the role of firm capabilities in vertical integration decisions. Strategic Management Journal, v. 17, n. 2, p. 129, 1996.

BALAKRISHNAN, S.; WERNERFELT, B. Technical change, competition and vertical integration. Strategic Management Journal, v. 7, n. 4, p. 347, 1986.

BEGUN, J. et al. Managed care, vertical integration strategies and hospital performance. Health Care Management Science, v. 4, n. 3, p. 181, 2001.

BRASIL. Agência Nacional De Saúde Suplementar - ANS. Informações sobre beneficiários, operadoras e planos, dados do setor. 2005. Disponível em: Acesso em: 08 set. 2005.

BURNS, L. et al. The financial performance of integrated health organizations. Journal of Healthcare Management, v. 50, p. 3, 2005.

BURNS, L.; KIMBERLY, J.; WALSTON, S. Owned vertical integration and health care: promise and performance. Health Care Management Review, v. 21, n. 1, p. 83, 1996.

BYRNE, M.; WALNUS, C. Incentives for vertical integration in healthcare: the effect of reimbursement systems. Journal of Healthcare Management, v. 1, p. 34, 1999.

CAMPOS, J. Artigo do presidente da FENASEG. 2006. Disponível em: . Acesso em: 08 mar. 2006.

CARLTON, D.; PERLOFF, J. Modern industrial organization. 2nd ed. New York: Harper Collins College Publishers, 1994.

CASALINO, L.; ROBINSON, J. Vertical integration and organizational networks in health care. Health Affairs, v. 15, n. 1, p. 7, 1996.

EISENHARDT, K. Control: organizational and economic approaches. Management Science, v. 31, n. 2, p. 134, 1985.

GROSSMAN, S. J.; HART, O. D. The costs and benefits of ownership: a theory of vertical and lateral integration. The Journal of Political Economy, v. 94, n. 4, p. 691, 1986.

HARRIGAN, K. Vertical integration, outsourcing and corporate strategy. Washington D.C.: Beard Books, 2003.

HIGGINS, C.; MEYERS, E. Managed care and vertical integration: implications for the hospital industry. Hospital & Health Services Administration, v. 32, n. 3, p. 3-19, 1987.

JOSKOW, P. Vertical integration and long-term contracts: the case of coal burning eletric generation plants. Journal of Law, Economics and Organization, v. 33, n. 1, 1985.

KLEIN, B.; CRAWFORD, R.; ALCHIAN, A. Vertical integration, appropriable rents, and the competitive contracting process. Journal of Law, Economics and Organization, v. 21, p. 297, 1978.

KROPF, J. Segundo seminário nacional sobre o complexo industrial de saúde. Rio de Janeiro, 2003.

MAHONEY, J. The choice of organizational form: vertical financial ownership versus other methods of vertical integration. Strategic Management Journal, v. 13, n. 8, p. 559, 1992.

MALIK, A.; TELLES, F. Administração estratégica em hospitais. Núcleo de Publicações e Pesquisa EAESP-FGV, 2003. Relatório de pesquisa.

MATTAR, N. Pesquisa de marketing. 5. ed. São Paulo: Atlas, 1999.

MPOYI, R. Vertical integration: strategic characteristics and competitive implications. Competitiveness Review, v. 13, n. 1, p. 44, 2003.

NATIONAL CENTER FOR HEALTH STATISTICS. Center for Diseases Control. State of Aging and Health in America Report. Atlanta, 2007.

ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT - OECD. Health policy brief, aging and technology. Paris, 1998. Working paper. Disponível em: . Acesso em: 15 abr. 2006.

ORGANIZAÇÃO MUNDIAL DE SAÚDE - OMS. Relatório de indicadores globais. Genebra, 2004.

PORTER, M.; TEISBERG, E. Redefining health care: creating value-based competition on results. Harvard Business Review Press, 2006

WILLIAMSON, O. Transaction costs economics: the governance of contractual relations. Journal of Law and Economics, v. 22, n. 1, p. 233, 1979.

5883a3c67f8c9da00c8b4631 1574685864 Articles
Links & Downloads

Production

Share this page
Page Sections