This article discusses: First, the importance of including the political dimension in the institutional diagnose, since the rationale of governmental decisions and actins is that of the conflictant interest e struggle for spaces of power in side the state bureaucracy rather than the logics of rational and neutral technical-administrative plans. Second reviews the concept o f bureaucracy from different theoretical approaches so as to show new analytical possibilities for public administration studies. Third, focuses "sanitary bureaucracy" as an analytical unity to be investigated and understood at the lights of the conceptual framework already discussed. Finally, points out the relevance of the approach not only for public health administration research and teaching but also for designing tactical-operational plans to viabilize the Brazilian Sanitary Reform.