this is a literature review of theoretical and methodological issues on health care evaluation of research and technical reports. conceptual frameworks, approaches, subject matter, strategies, and study designs are identified and analyzed. evaluative research designs are compared with epidemiological ones. a diverse terminology was encountered, and many methodological problems in the literature were examined. the incorporation of evaluative procedures in health planning or health policy-making and administration is still limited in brazil, particularly at the local level. recent implementation of projects for the reorganization of the health services system based on the administrative autonomy of local health units raises the need for more appropriate strategies aimed at health care evaluation. perspectives for the development of alternative strategies are indicated.