WORK MANAGEMENT IN HEALTHCARE: MEANING AND USE OF EXPRESSION IN THE BRAZILIAN HISTORICAL CONTEXT

Abstract The expression ‘work management in healthcare’ began to be used in Brazil after the 12a National Conference of Health, replacing ‘human resource’. The aim was analyze the meanings attributed to the use of the term ‘work management in healthcare’ based on the Brazilian historical context. This research developed a scoping review in the Lilacs database, between 1990 and 2010. Among 436 eligible studies, 34 were included. These publications presented numerical growth especially after the 3rd National Conference of Work Management and Education in Healthcare at 2006. The content was synthetized in five main topics: conceptualizing of work management in healthcare, policy formulation, and participation of workers in the work process, labor precarization and new challenges. Despite the consensus about the complexity of the expression, distinct aspects are explored by the authors depending of political, social and economic contexts during the construction of thought. The theoretical discussions should support changes on practices of management and on culture of production modeling, but practical changes are scarce, generating a question that was not completely answered: does work management in healthcare represent a simple terminology exchange or paradigm shift?

摘要 “医疗保健领域工作管理（work management in healthcare）”这一表述于巴西第12届全国卫生大会之后开始在当地使用，取代了此前的“人力资源（human resource）”表述。本研究旨在基于巴西历史语境，剖析赋予该术语的多重内涵。研究团队于1990年至2010年间，在Lilacs数据库中开展了一项范围综述（scoping review）。在初筛符合纳入标准的436项研究中，最终纳入34项。相关文献的发表数量呈现明显增长趋势，尤其在2006年第三届全国医疗保健工作管理与教育大会之后。研究内容被归纳为五大核心主题：医疗保健领域工作管理的概念界定、政策制定、劳动者对工作过程的参与、劳动非正规化（labor precarization）以及新兴挑战。尽管学界对该术语的复杂性已达成共识，但不同研究者会结合思想构建过程中的政治、社会与经济语境，探讨其不同维度。尽管理论探讨本应助力管理实践与生产模式文化的变革，但实际变革却寥寥无几，由此催生了一个尚未得到圆满解答的问题：医疗保健领域工作管理究竟只是术语的简单替换，还是范式层面的转变？