Desafios na implementação do custeio ABC em hospitais brasileiros e seus impactos na gestão de custos

Abstract

The growing demand for efficiency in hospital management has increased interest in methodologies that improve cost control. In this context, Activity-Based Costing (ABC) emerges as an alternative to the limitations of traditional methods. This study analyzes the main challenges faced by Brazilian hospitals in implementing ABC, focusing on the role of partners and employees, resistance to change, and managerial impacts. A qualitative, exploratory approach was adopted, based on a literature review of 41 articles published over the last 24 years. The results indicate that, although ABC enhances costing accuracy, information transparency, and decision support, its adoption remains limited due to organizational and technical barriers. Notably, cultural resistance among professionals, the absence of integrated information systems, upfront implementation costs, and training gaps stand out. Successful initiatives involve managerial sponsorship, process mapping, systems integration, and continuous training, contributing to better resource allocation, performance assessment, and economic sustainability. It is concluded that overcoming the identified barriers is a condition for ABC to generate value for cost management in Brazilian hospitals.