Advisor(s)
Abstract(s)
No atual contexto da saúde o desenvolvimento das técnicas de custeio para o controlo e
análise dos custos nas organizações hospitalares, tem sido um fator determinante para o
desempenho das mesmas e apresenta-se como uma importante ferramenta no processo de
gestão. Este projeto tem como objetivo a aplicação do custeio baseado em atividade e tempo,
sigla do inglês Time-Driven Activity-Based Costing (TDABC), no Hospital da Trindade. A
sua implementação na instituição constitui uma mais-valia para a obtenção de informações
precisas e confiáveis. Nesta medida, surge uma questão basilar: será que o reembolso feito
pelas mais diversas entidades remunera os custos dos atos cirúrgicos? No decorrer do estudo
foram utilizadas varias técnicas de colheita de dados e análise documental, de forma a
proporcionar elementos capazes na identificação e aprofundamento do setor, bem como os
serviços realizados e os recursos consumidos. A amostra selecionada para o estudo refere-se
aos atos cirúrgicos mais praticados na organização no corrente ano. A partir do propósito
apresentado, determinou-se os custos associados a cada ato cirúrgico bem como os valores de
reembolso feitos pelas respetivas entidades convencionadas com a instituição. Constatou-se
que os valores reembolsados pelas entidades convencionadas ficaram substancialmente
abaixo dos custos, variando de -5% na apendicectomia a -63% no tratamento de hérnia
inguinal bilateral. A magnitude das variações entre o máximo e mínimo dos valores
reembolsados sugere que as entidades convencionadas trabalham com metodologias não
convergentes na formação das suas tabelas de preços. A partir dos resultados apresentados,
pretende-se viabilizar a implementação do TDABC nas organizações hospitalares em geral.
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.
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.
Description
Keywords
Custeio Baseado em Atividade e Tempo Custos hospitalares Controle de custo Time-Driven Activity-Based Costing Hospital costs Cost control