The Brazilian health organizations have been forced to increase its efficiency and effectiveness. Changes in hospitals are observed in ways of financing and remuneration, due to the introduction of new regulation agents. The aim of this study was to know how this reforming environment, with budgetary restrictions and new game rules, was inductive of institutional adaptations in a public university hospital. A case study was carried out within the Hospital of Federal University of Minas Gerais (HC/UFMG) in order to analyze the behavior of selected production indicators for the period between 1994 and 2000. To understand how the workers and the management perceived the changes, partially structured interviews with the directive body as well as focal groups with the workers were conducted. Findings showed that in order to find a path for survival in an unstable and turbulent environment, the HC/UFMG implemented organizational strategies for adaptation, increased production and search for new supportive partners.
State reform; health sector; efficiency; university hospital; public hospital
