Decision making process of outsourcing in municipal health departments

This pape r is to analyzes the decision making process of outsourcing at the health departments of Almirante Tamandaré and Fazenda Rio Grande, counties in the Curitiba metropolitan area, in the state of Paraná, Brazil. It presents the main aspects of outsourcing as a form of rendering public service. The paper is based on detailed interviews with managers who were decision makers and on documental analysis. After describing the two cases, the paper concludes that the ma in reasons for outsourcing are: greater agility and flexibility, and lower costs. It was aIs o evident that the health departments had difficulty in measuring the costs and the performance of the service suppliers. The paper also concludes that outsourcing, by itself, does not guarantee more efficiency or effectiveness. In the case of Almirante Tamandaré, so far the health department was satisfied. In case of Fazenda Rio Grande, it was clearly unsatisfied.