Gest？o pública por resultados: contrato de gest？o como indutor de melhorias em um hospital universitário

this paper examines the extent to which management contracts have achieved results in improving the performance of a university hospital. this is based on the assumption that success in contracting depends on changes in the organizational structure, in the production process and relations between agents to reduce the fragmentary character of public policy. the debate about cycles of management change was reviewed in the light of the new managerialism approach "theory of fragmentation" of public policy. document analysis and semi-structured interviews were used, and the data was interpreted by analyzing categorical content. the strategies and organizational changes resulting from contracting yielded results for the management model, increased hospital performance, defined control criteria and evaluation, changed the organizational structure, enabling a more decentralized and participatory management. we conclude that the changes resulting from management contracts positively impacted performance indicators, increasing efficiency and effectiveness and that it is possible to integrate health policy and education, avoiding the fragmentation of public policies.