Management strategies to expand access to supply of specialized services in the municipality of Rio de Janeiro, Brazil, between 2021 and 2024

Abstract This study is to describe the management models adopted by the capital city of Rio de Janeiro in the area of health units between 2021 and 2024. An ecological, time-series, descriptive study was carried out using public data from official systems and documentary analysis of formal partnership instruments signed by the Municipality of Rio de Janeiro. The results were presented by identifying the problem situation for each level of care and the alternative management model adopted by the Direct Administration. The evolution of health indicators during the period of change in management was analyzed. The Social Health Organizations model was resumed in the management of all Primary Health Care (PHC) units, with a return to PHC coverage and complete teams. In specialized care, Civil Society Oganizations were hired to set up surgical specialty centers in hospital units, with a five-fold increase in the number of surgeries offered. In hospital care, two models have gained prominence: the Municipal Public Company and the Public-Private Partnership.