Custeio de serviços de saúde numa IPSS

Abstract

In the current health context, the development of costing techniques for the control and analysis of costs in hospital organizations, has been a determining factor for their performance and presents itself as an important tool in the management process. The aim of this project is the implementation of costing based on both activity and time, Time-Driven Activity-Based Costing (TDABC), at Hospital da Trindade. Its implementation in the institution is an asset for obtaining accurate and reliable information. To this extent, a key question arises: will the reimbursement made by the various entities cover the costs of surgical procedures? During the study, several techniques for data-collecting and analysis of documents were used, to provide capable elements of identifying and deepening the sector, as well as the services performed and the resources consumed. The selected sample for the study covers the most performed surgical procedures in the organization in the current year. Taking into account the presented purpose, the costs associated with each surgical procedure as well as the reimbursements made by the respective entities, agreed with the institution, were determined. It was found that the values reimbursed by the agreed entities were substantially below the actual costs, ranging from -5% in appendectomy to -63% in the treatment of bilateral inguinal hernia. The magnitude of variation between the maximum and the minimum values reimbursed, suggests that the agreed entities work with non-converging methodologies in the creation of their price lists. From the results presented, it is intended to facilitate the implementation of TDABC in hospital organizations in general.

Date of Award	6 Feb 2013
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Maria Luisa Anacoreta Correia (Supervisor)