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Advisor(s)
Abstract(s)
A contabilidade de custos na área da saúde, revela-se fundamental como instrumento de informação para a tomada de decisão, num setor onde os gestores são cada vez mais incitados a providenciar mais e melhores cuidados a preços inferiores.
O principal objetivo deste estudo de caso, foi determinar o custo de um dia de internamento numa unidade de cuidados continuados, para três tipologias de doente caracterizados segundo o grau de dependência, com base nos custos reais da atividade utilizando a metodologia Time-Driven Activity-Based Costing. A escolha da metodologia de custeio, relaciona-se com as características do modelo e da instituição em análise. Assim, o TDABC revelou-se mais adaptável, simples de construir e um método que reflete melhor a realidade e complexidade de um hospital, relativamente a outras metodologias, nomeadamente o Activity-Based Costing.
A análise realizada permitiu identificar os principais processos e custos associados e afetá-los aos doentes tipos e concluir que o custo real de um dia de internamento de um doente moderadamente dependente e totalmente dependente é superior ao preço protocolado com a Rede Nacional de Cuidados Continuados o que em caso de convenção conduz à necessidade de reduzir custos para tornar o projeto sustentável. Permitiu ainda determinar o preço a praticar, numa situação de exploração privada. Conclui-se que numa perspetiva de exploração privada, o projeto da unidade de cuidados continuados é sustentável.
Ao longo da realização deste trabalho deparei-me com limitações, nomeadamente a ausência de um sistema de informação que permita a obtenção dos custos reais da instituição, a utilização de critérios de repartição que podem influenciar a precisão dos resultados e o facto de realizar este estudo em termos prospetivos e não com dados reais de consumo da instituição. Sugere-se que logo que possível se atualize este sistema de custeio, atualizando tempos e afetação dos profissionais e dos recursos, procurando um sistema cada vez mais preciso e que seja cada vez mais reflexo da realidade da OT.
In an industry where managers are increasingly encouraged to provide more and better care at lower prices, cost accounting in healthcare becomes vital as information tool for decision making. The main objective of this case study was to determine the cost of a day in a continuing care unit for three types of patients characterized according to the degree of dependence, based on the actual cost of the activity using the methodology Time-Driven Activity-Based Costing. The choice of this costing methodology is related to the characteristics of the model and the institution in question. TDABC has proved to be more adaptable and easier to construct. It is a method that better reflects the reality and the complexity of the hospital and complexity relative to other methodologies, including the activity-based costing. The analysis has allowed us to identify key processes and associated costs, and affect them to the types of patients. The actual cost of a day in a continuing care unit for moderately dependent and totally dependent patient is higher than the contractually specified price by the National Network for Integrated Continuous Care. In case of convention it is necessary reducing costs to make the project sustainable. This study has also permitted to find the price to charge in a situation of private exploitation. Analyzing the organization's ability to generate positive results we might conclude that in a perspective of private exploitation, the projected unit continuing care unit is sustainable. Throughout this work I came across with limitations, particularly the lack of data provided by the information system that allows me or us to obtain obtaining the actual costs of the institution, the use of allocation criteria that may influence the accuracy of the results, and the fact that this study is prospective. It is suggested to update this costing system as soon as possible, updating allocation of professional and resources time, seeking an increasingly accurate system that could improve the reality of OT .
In an industry where managers are increasingly encouraged to provide more and better care at lower prices, cost accounting in healthcare becomes vital as information tool for decision making. The main objective of this case study was to determine the cost of a day in a continuing care unit for three types of patients characterized according to the degree of dependence, based on the actual cost of the activity using the methodology Time-Driven Activity-Based Costing. The choice of this costing methodology is related to the characteristics of the model and the institution in question. TDABC has proved to be more adaptable and easier to construct. It is a method that better reflects the reality and the complexity of the hospital and complexity relative to other methodologies, including the activity-based costing. The analysis has allowed us to identify key processes and associated costs, and affect them to the types of patients. The actual cost of a day in a continuing care unit for moderately dependent and totally dependent patient is higher than the contractually specified price by the National Network for Integrated Continuous Care. In case of convention it is necessary reducing costs to make the project sustainable. This study has also permitted to find the price to charge in a situation of private exploitation. Analyzing the organization's ability to generate positive results we might conclude that in a perspective of private exploitation, the projected unit continuing care unit is sustainable. Throughout this work I came across with limitations, particularly the lack of data provided by the information system that allows me or us to obtain obtaining the actual costs of the institution, the use of allocation criteria that may influence the accuracy of the results, and the fact that this study is prospective. It is suggested to update this costing system as soon as possible, updating allocation of professional and resources time, seeking an increasingly accurate system that could improve the reality of OT .
Description
Keywords
Custeio baseado em atividades e tempo Controlo de custos Pricing RNCCI Time-Driven Activity-Based Costing Cost control National Network for Integrated Continuous Care