Doenças do aparelho circulatório: diagnóstico situacional sobre a gestão dos custos em Unidade de Clínica Médica de um hospital público de ensino

Abstract

Inpatient units, such as the Medical Clinic, admit patients from different specialties, with different levels of care complexity, which causes higher costs and, consequently, makes the recognition of costs fundamental for better management of results and decision-making. Despite the importance of investigating the costs caused by patient care in the Medical Clinic and the abundant literature on costing methods, there is still a shortage of studies that evaluate the calculation of costs and allocation of resources in hospitalization units such as the Medical Clinic, restricting itself to the calculation of direct costs in isolated contexts. In view of this, the present study aimed to identify and describe the productive structure, as well as the processes related to cost management of the internal medicine unit of a public higher education hospital, through a situational diagnosis. This is a descriptive case study with a mixed approach with the intention of carrying out a situational diagnosis of a Medical Clinic Unit of a public hospital in the Minas Gerais triangle between the period of October 2020 to May 2022, considering the year 2019 as reference. For data collection, electronically available bibliographic sources were consulted, documents provided by the sectors/units of the hospital in text editor format (docx), Portable Document Format, Microsoft Office Excel spreadsheets and illustrations, as well as, semi-structured interviews with immediate supervisors and professionals working in the units/sectors of interest. After, as a product of the present dissertation, two educational videos were developed. The results demonstrate that the flow of cardiac patients to the Medical Clinic Unit can occur through different sectors, with a complex productive structure. The service in this unit generates direct, indirect, fixed and variable costs, although the calculation of costs is not carried out in the referred hospital, but the method of absorption through the calculation of the procedures carried out through the analysis of the medical records. In short, he realized that the Medical Clinic Unit has a complex productive structure aimed at patients with cardiovascular disease, which generates high costs and that despite the need to calculate costs, the unit opts for the absorption method. Thus, two videos were developed about the methods of calculating health costs and medium and high complexity health costs with the intention of informing, instructing and sensitizing servers, students and users about the importance of efficient management of health costs for sustainability of the Unified Health System.