Perdas financeiras de órteses, próteses e materiais especiais no faturamento hospitalar: Um estudo de caso das cirurgias do hospital de clínicas de Uberlândia (MG)

Abstract

This research was carried out at a federal public University Hospital (HU, in Portuguese abbreviation) in Uberlândia, Minas Gerais, Brazil, with the main objective of analyzing the financial losses of Orthoses, Prostheses and Special Materials (OPME), in the context of billing, by the Unified Health System (SUS). The Clinical Hospital of the Federal University of Uberlândia (HC-UFU), where this study was developed, stands out as a large organization, as it offers medium and high complexity services, provides care to users of the aforementioned city and region and plays an essential role in teaching and research, factors that motivates the development of this investigation. The data collected refer to the years 2016 to 2021 and were obtained through control spreadsheets completed by the billing sector of HC-UFU, which contain information related to OPME that were not recorded in billing. In this sense, exploratory and documentary research was carried out, through a combined study of quantitative and qualitative methods. From an exploratory perspective, information was concatenated and data collected to investigate OPME losses in the billing of HUs, a topic that has not been widely explored in the academic literature. To this end, descriptive statistics were performed to measure the financial losses of OPME and investigate the main reasons for such occurrences, by applying forms directed to the teams responsible for surgical procedures. The results revealed that the financial losses associated with OPME in hospital billing represent losses and significantly affect the revenue of the HU. Regarding the specialties analyzed, it was shown that the Cardiology, Neurology and Orthopedics/Traumatology groups presented the highest number of cases of OPME losses, whose main causes in billing, according to the interviewees, include the limitation of the Management System of the Table of Procedures, Medications, Orthoses, Prostheses and Special Materials (SIGTAP), problems related to surgical programming, as well as the lack of knowledge, which highlights the importance of training and qualification of all those involved in the process. Through this study, it was possible to acquire information about OPME losses, highlighting the need to improve control and management of materials, in addition to implementing policies to reduce financial losses. It is expected that the reflections of this study will contribute to addressing the problem effectively and improving the management of resources and the quality of public health services offered to the population.