The formation of healthcare consortia is a management strategy adopted by a number of cities in Brazil in order to minimize the difficulties the population has in access to services of greater technological complexity. As administrators are the main governmental actors in the promotion of this strategy, the aim of the present study was to identify the motives, expectations and difficulties faced by the mayors, and secretaries of health that make up a healthcare consortium undergoing a formation process in the rural, coastal zone of the state of Pernambuco. A descriptive, qualitative, case study was conducted. Data collection was carried out through semi-structured interviews held with mayors and secretaries of health of the municipalities participating in the consortium. Data were analyzed by means of content analysis, using the NVivo 2.0 software program. The administrators cited difficulty in access to specialized services and the high cost of transporting patients to distant locations for treatment as motives for the formation of the consortium. With the implantation of this healthcare strategy, the expectations are a reduction in costs regarding patient transportation, an increase in access to services of greater complexity, and negotiations with other spheres of government. The main difficulties faced are political-partisan conflicts and excessive bureaucracy. Although there were no considerable divergences in the administrators' perceptions, it was evident that those who initiated the formation of the consortium offered a deeper, more detailed discourse, thereby demonstrating greater involvement when compared to those who offered continuity to the process.
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