Between legality and the quality of care: A critical analysis of audits in the Unified Health System in Minas Gerais

Abstract

This article critically analyzes audit reports conducted within the Unified Health System by the State Health Secretariat of Minas Gerais, with the aim of identifying patterns of non-compliance and proposing technical criteria for prioritizing scheduled audits. This is a documentary ecological study with a mixed-methods approach that examined 629 audits completed between 2011 and 2024, covering 333 municipalities, using data extracted from the SUS Audit System. Of these audits, 593 (94.3%) presented non-compliance findings, totaling 11,816 records. Textual analysis was performed using IRaMuTeQ software, applying word cloud,
similitude graph, descending hierarchical classification, and factorial correspondence analysis. Two main axes of fragility were identified: care-related issues, including access barriers, failures in Primary Health Care, and precariousness of the Family Health Strategy; and governance-related issues, such as lack of planning, regulatory gaps, and inadequate use of resources. A predominance of technical-financial vocabulary and low user-centeredness was observed. The study concludes that, despite the significant volume of audits, there are gaps in the critical systematization of findings, which limit their potential to drive improvements in management and quality of care within the SUS.