A enfermagem e o gerenciamento de custos

Dialysis treatment has also developed greatly, due to scientific and technological advances, and it has happened more and more frequently at ICUs.Since the advent of dialysis treatments andICUs, a steady increase in the severity of baseline diseases has been observed, which present AcuteRenal Failure (ARF) as an associated complication (1) . ARF, which affects patients hospitalized atICUs, presents a particular mortality and epidemiological profile (2) . The Brazilian Society of Nephrology (BSN) informs that these patients' mortality is close to 50% and that the condition of current patients with ARF is more severe than formerly (3) .Despite efforts and investments in the area, the mortality of patients with ARF in ICUs remains high.Renal substitution therapy is a complex procedure, demands precise equipment, specific material and duly trained professionals. It involves the multiprofessional ICU and Dialysis teams so that they can work together; because the first attends the patient directly and the later fully masters the specialty. Thus, the association between these parts is necessary in order to increase the actions' effect and save resources.The limited availability of resources is a serious problem that affects not only public hospitals, which makes it necessary to identify the costs in care delivery. CASES AND METHODThis is an exploratory, descriptive, retrospective, Thus, to calculate the nurses' labor cost in each procedure, the hour cost of R$ 22.50 was multiplied by the total hours of each procedure. Input cost calculationIn the analysis of each procedure registered on the patients' files, the quantities of material, medication and volumes of solutions used were computed and, next, this information was registered in a worksheet.Unit cost data of the inputs were obtained by consulting the Material Administration System (MCS), an internal computer system. Some medications and solutions produced in the Institutions were consulted directly at the Pharmacy Division.Three kinds of solutions can be used at the institution. Two are industrialized (peritoneal dialysis and lactate-based dialysis) and the other is prepared at the unit itself by the nurse who performs the procedure. Two kinds of solutions can be used for the anticoagulation: citrate and heparine solutions or, due to the patients' clinical condition, only washing the system with physiological solution more intensely, according to the medical prescription.Some standards were set for the charge of some inputs, for example: the infusion pump is changed every 72 hours, according to institutional routine; a piece of 20cm of wide microporous adhesive tape used was considered in the turnoff for computation, and others.After finishing the cost calculation of each of the 93 procedures in the data collection instrument, amounts were transferred to an electronic worksheet for analysis with the study variables. RESULTS Socio-Demographic and Clinical Characterization of PatientsMen predominated (62%) in the sample. The ARF diagnosis was described for 76% of t...

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“…The need to know the costs involved in care delivery is urgent in decision making on resource allocation (4) . …”

Section: Arf Which Affects Patients Hospitalized Atmentioning

confidence: 99%

Expenditure survey on continued veno-venous hemodialysis procedure in the intensive care unit

Secco

Castilho

2007

Rev. Latino-Am. Enfermagem

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“…A crescente elevação dos custos na saú-de trouxe aos profissionais da área a necessidade de adquirir conhecimentos teóricos sobre o tema e, conseqüentemente, sua aplicação na realização de estudos, em que se busca a racionalização na alocação de recursos e a otimização de resultados (7) . Na atualidade, as enfermeiras estão sendo envolvidas em decisões financeiras e no planejamento orçamentário das instituições onde trabalham, constituindo um nível decisório im-portante na alocação de recursos humanos, materiais e físicos, visto que estabelecem prioridades de serviços nas unidades de trabalho; decidem quem prestará os cuidados e quanto tempo será despendido para sua realização e quais recursos serão empregados.…”

Section: Introductionunclassified

Levantamento do custo do processo admissional de técnico de enfermagem de um hospital de ensino

Okano

Castilho

2007

Rev. esc. enferm. USP

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Este estudo teve como objetivo contribuir para a gestão de custo do processo admissional de técnicos de enfermagem pelo mapeamento e mensuramento do custo direto das principais atividades desse processo. O estudo exploratório, retrospectivo, documental, na modalidade de estudo de caso foi realizado no Serviço de Apoio Educacional do Hospital Universitário da Universidade de São Paulo. O processo admissional foi dividido em cinco subprocessos: planejamento, recrutamento, seleção, contratação e treinamento admissional. Os resultados mostraram que o custo total direto do processo admissional foi de R$ 6.359,90 e o subprocesso seleção foi o que mais consumiu recurso, com R$ 3.416,40, representando R$ 53,72% do total. Cada candidato contratado custou R$ 635,99.

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“…Because of a complex national conjecture, the health sector, in the private domain, has faced serious financial burdens without, however, having the chance to transfer the cost increases automatically to the prices of the services mainly because of the factors of market competition, the pressure of society and health plans, and a certain government control over prices (1) .…”

Section: Introductionmentioning

confidence: 99%

“…This setting brought upon administrators and health professionals the need to obtain knowledge about costs, search for measures to balance costs with other financial resources, as well as to gain the competency to allocate resources and optimize outcomes (1) . Therefore, the concerns of health administrators have focused on surveying and controlling hospital costs and finding contention measures especially concerning the waste (2) .…”

Section: Introductionmentioning

confidence: 99%

Levantamento das principais fontes de desperdício de unidades assistenciais de um hospital universitário

Castilho

Castro

Couto

et al. 2011

Rev. esc. enferm. USP

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Este estudo teve como principais objetivos levantar os diferentes tipos de desperdício, suas causas e sugestões para eliminá-los, segundo a opinião de profissionais de enfermagem e médicos atuantes em unidades de Clínica Médica, Clínica Cirúrgica, Pediatria, Alojamento Conjunto e Berçário; e estimar o custo da principal fonte de desperdício nessas unidades. Trata-se de um estudo descritivo, exploratório, com abordagem quantitativa realizado no Hospital Universitário da Universidade de São Paulo. A amostra foi constituída por 189 profissionais de enfermagem e médicos. O desperdício relacionado aos materiais (36%) foi o mais apontado por todas as categorias profissionais seguido pelo desperdício de estrutura física (27%). Os materiais desperdiçados mais citados foram os medicamentos, pacotes de curativo, papel sulfite e dispositivos de infusão. O custo do desperdício anual com materiais nas unidades estudadas pode girar em torno de R$ 479.262,86.

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A enfermagem e o gerenciamento de custos

Cited by 36 publications

References 2 publications

Expenditure survey on continued veno-venous hemodialysis procedure in the intensive care unit

Expenditure survey on continued veno-venous hemodialysis procedure in the intensive care unit

Levantamento do custo do processo admissional de técnico de enfermagem de um hospital de ensino

Levantamento das principais fontes de desperdício de unidades assistenciais de um hospital universitário

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