Diagnóstico situacional sobre a gestão de custos na unidade de terapia intensiva coronariana de um hospital de ensino federal

Abstract

Maintaining a level of quality in hospital services, especially in those that are committed to the training of future health professionals, as is the case of federal public university hospitals, is a constant challenge since it depends on the transfer of funds by SUS. These funds are often insufficient to cover costs in the face of the demand for health services. Cost control is a complex practice nevertheless an extremely necessary measure. Its efficiency as an administrative technique, permits managers to obtain information to formulate significant decisions. Consequently, some questions arose concerning the characteristics of the processes related to the management and cost calculations of the activities performed in the Coronary ICU of the Clinic Hospital of the Federal University of the Triângulo Mineiro (HC-UFTM), mainly about the structure and efficiency of these processes. In this regard, to carry out a situational diagnosis to contribute to the cost management in the unit, a case study structured in three stages was performed. The different data collection techniques were employed to ensure that the depth required of the study correlates with its complexity. In the first stage, through the process of mapping, the cardiac patients' flows within the institution and the final processes of the ICU were mapped. In the second stage, through semi-structured interviews, documentary analysis and on-site observation, it was possible to perform a general characterization of the unit, identify the profile of its costs, as well as the current cost and billing calculation structure. In the third stage, an action plan was presented, elaborated as the proposal for a prospective study to determine costs in the unit from the perspective of Total Absorption Costing methodology. In addition to the action plan, another product of this work was the development of a booklet on cost management in the hospital environment aimed at health professionals. The results obtained show the need to validate and implement a cost calculation method that meets the needs of the unit and hospital management.