Accountability is one of the modern ways of controlling public administrationso that it is efficient and meets society s expectations. Subdivided into vertical andhorizontal modalities, the first corresponds to society s participation in publicadministration, a social action that has intensified as the service is not provided tosatisfaction. And the horizontal form takes place through the actions of controlinstitutions, both those traditionally legitimized and those that exercise control in apractical way. Among the institutions that act as agents of accountability, it wasfound that the practical extrajudicial work of the Public Defender s Office of theState of Rio de Janeiro contributes to the improvement of the SUS through thecontrol and monitoring of public policy. This control and monitoring is not aimedat punishing the public manager, but at achieving goals and a quality public service,through democratic accountability. Achievement stems from the institution scollective action, which is still recent, but has shown positive results for the SUS,promoting benefits not only for those who use the institution, but for society as awhole. This improvement in the provision of public services is related to thedemocratic quality of the country and the legitimacy of public managers. Therefore,the research found that the institution s work fulfills, to the fullest extent, what theConstitution states, that it is an expression and instrument of the democratic regime.