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Resumo(s)
A grande capacidade de iniciativa do setor privado da saúde para a
melhoriaconstante da eficiência dos custos, justificada pelas poupanças
significativas a realizar neste domínio,tem vindo a propagar-se de alguma
forma para o setor público, que agora começa também a obter resultados
nestecapítulo.
O principal objetivo deste relatório de estágio é o de avaliar a eficiência
operacional das cirurgias do Centro Integrado de Cirurgia de Ambulatório
(CICA), unidade hospitalar do CHP. Selecionando uma amostra de 95
observações correspondentes a 19 procedimentos cirúrgicos, pretendeu-se
analisar o impacto em termos de custos no consumo diário de material de
consumo clínico descartável, nomeadamente na existência de vantagens na
utilização de packs cirúrgicos com material descartável, de uso único.
O peso da rubrica dos Consumos de Mercadorias Vendidas e Matérias
Consumidas nos pesos totais, da qual fazem parte os Produtos Farmacêuticos e
o Material de Consumo Clínico (MCC), justifica a decisão tomada de centrar
este trabalho no MCC.
A Metodologia adotada, caracterizada por ser um método de investigação
qualitativo, assenta numa base teórica-empírica, visto tomar como sustentáculo
o referencial teórico e os fundamentos da área em estudo, a análise de Custos
Hospitalares. Numa fase inicial, depois de formulada a pergunta de partida:
“Será possível avaliar a eficiência operacional da atividade do CICA?”, que
orientou todo o trabalho desenvolvido, e obtidas todas as autorizações
necessárias, procedeu-se a uma abordagem exploratória sobre o tema em
questão, através de uma recolha exclusiva de documentos e dados. A conclusão principal retirada do cálculo do custo médio em MCC por tipo
de atividade e análise do respetivo desperdício, foi a existência de desperdício
de material em todos os procedimentos cirúrgicos que utilizam pack. Na análise
comparativa entre Aquisição de pack VS. Aquisição de material avulso, concluise
que, em quatro dos cinco packs adquiridos não se realizam poupanças
significativas entre adquirir packs ou utilizar o material comprado avulso.
The growing capability of the healthcare private sector for cost eficiency improvement, fundamented by the significant savings that stem from these initiatives, has somehow found its way into Portuguese public healthcare, that now starts showing interesting results in this domain. The first and foremost objective of this internship report is the evaluation of the surgeries operational cost eficiency of the Integrated Center for Ambulatory Surgery's (CICA) of Porto's Hospitalar Centre. A selection of 95 observations corresponding to 19 surgical procedures was used, to analyse the cost impact of the daily consumption of the clinical, single-use, disposable material, namely for the appreciation of the advantages found in using surgical disposable material packs. The weight of the accounting rubric of Goods Sold and Material Consumption, of which the Farmaceutical Products and the Clinical Material Consumption (MCC) are a part of, justifies the decision for focusing this work on MCC. The adopted qualitative research methodology is based on a theoreticalempirical basis, given that it hinges on the theoretical referential and the fundamentals of the area under study – hospitalar cost analyses. At an initial stage, after formulating the thesis question: “whether it would be possible tp evaluate the operational efficiency of CICA’s activity?”, that would centre the entire work, and obtaining the required permissions to carry out the observations during the surgery practices, the exploratory phase of the thesis work was undertaken through appropriate documentation and data gathering. The main conclusion of this work, withdrawn from the average MCC cost by activity type and analysis of the respective waste, was the exsitence of material waste in all surgical procedures using disposable material packs. At the comparative analysis for pack vs. separate disposable material acquisition, it can be verified that in four out of five cases there are no significant savings in the pack usage choice.
The growing capability of the healthcare private sector for cost eficiency improvement, fundamented by the significant savings that stem from these initiatives, has somehow found its way into Portuguese public healthcare, that now starts showing interesting results in this domain. The first and foremost objective of this internship report is the evaluation of the surgeries operational cost eficiency of the Integrated Center for Ambulatory Surgery's (CICA) of Porto's Hospitalar Centre. A selection of 95 observations corresponding to 19 surgical procedures was used, to analyse the cost impact of the daily consumption of the clinical, single-use, disposable material, namely for the appreciation of the advantages found in using surgical disposable material packs. The weight of the accounting rubric of Goods Sold and Material Consumption, of which the Farmaceutical Products and the Clinical Material Consumption (MCC) are a part of, justifies the decision for focusing this work on MCC. The adopted qualitative research methodology is based on a theoreticalempirical basis, given that it hinges on the theoretical referential and the fundamentals of the area under study – hospitalar cost analyses. At an initial stage, after formulating the thesis question: “whether it would be possible tp evaluate the operational efficiency of CICA’s activity?”, that would centre the entire work, and obtaining the required permissions to carry out the observations during the surgery practices, the exploratory phase of the thesis work was undertaken through appropriate documentation and data gathering. The main conclusion of this work, withdrawn from the average MCC cost by activity type and analysis of the respective waste, was the exsitence of material waste in all surgical procedures using disposable material packs. At the comparative analysis for pack vs. separate disposable material acquisition, it can be verified that in four out of five cases there are no significant savings in the pack usage choice.
Descrição
Palavras-chave
Serviço Nacional de Saúde Custos hospitalares Sistemas de custeio tradicionais Activity-based costing National Health Service Hospital costs Traditional costing systems