Decision making process and modes of governance: A comparative study between Brazilian and British hospitals

This study was carried out to investigate similarities and differences in the decision-making process of managers (both, administrative and/or clinicians) within hospitals, taking as references Brazil and Great Britain and considering the cost information use. Exploratory and quantitative survey methods were used to test research questions. The research was undertaken in hospitals of the West Midlands Region/Great Britain and Minas Gerais State/Brazil. Hence, 26 hospitals in Great Britain and 22 in Brazil were detected as eligible and 150 intermediate level managers were randomly selected as units of research in each country. These organisations were considered public and possessing common and compatible characteristics with the intended research. After conducting the survey, using a structured questionnaire, semi-structured interviews with middle managers at chosen case study hospitals were undertaken. This work used quantitative survey methods to test the research questions but further understanding is gained through the use of case study interviews. In the cases analyzed, it was possible to identify significant differences in the decision making process considering the use of cost information in hospitals. This work also allowed inferences between the modes of governance in terms of the decision making process. The hospitals managers should curb situations that increase opportunism in decision-making process due to efficiency of process and control of costs procedures