DISTRIBUTION OF PUBLICLY MANAGED ACCREDITED HEALTH SERVICES IN BRAZIL ACCORDING TO THE LEVELS OF THE NATIONAL ACCREDITATION ORGANIZATION (ONA)

Abstract

Accreditation Organization (ONA). Method: This is a cross-sectional, observational study with a quantitative approach, based on documentary analysis of public records available on the National Accreditation Organization website. All public health services with active accreditation at the time of data collection (December 2025) were included, excluding duplicate, incomplete, suspended, or canceled records. The analyzed variables included accreditation level, State (Federative Unit), type of service, and number of records per category. Descriptive statistical analysis was performed using absolute and relative frequencies. Results: A total of 522 accredited public health services were identified. The majority were classified at the Accredited level (Level 1), accounting for 391 services (74.9%), followed by Accredited with Excellence (Level 3), with 90 services (17.2%), and Fully Accredited (Level 2), with 41 services (7.9%). The highest geographic concentration was observed in the state of São Paulo, particularly among Primary Health Care services at the initial accreditation level. Higher accreditation levels were predominantly associated with hospital services and greater care complexity, with lower geographic dispersion. Regional inequalities were identified, with excellence concentrated in states with greater technical and managerial capacity. Conclusion: Public management accreditation in Brazil is predominantly concentrated at the initial level, indicating that progression to higher accreditation levels remains limited. The findings highlight structural and regional disparities and reinforce the need for public policies aimed at strengthening management practices, expanding the culture of quality, and broadening access to accreditation across the country.