A análise de custos de serviços médico-hospitalares por margem de contribuição como instrumento de decisão estratégica e vantagem competitiva

Abstract

Abstract: The hospital organization is characterized by the need for continuous technological updating and permanent technical training of its human resources, in order to generate and offer services efficiently and effectively, that is, high levels of quality and safety to the patients using this system. The Health Sector in Brazil is one of the most complex in the service industry, especially when investigating its dynamic demand, and also, regarding the issues of economic and financial feasibility studies, since these organizations bring together numerous medical assistance activities. of high complexity, whether of a therapeutic and/or diagnostic nature. As a result of this characteristic, there is a gradual and continuous growth of costs in the health area, and with the limitations imposed by the customers of these hospital services, it becomes necessary to adopt systems that provide more accurate information on the performance and management of this organization for the decision-making process. In particular, in recent years, there has been an intensification of references and cost studies as an important function in the management of information for decisions within Hospitals. This study focuses precisely on Cost Management in High Complexity Hospitals, where it appears that one of the major current concerns in this sector is the development of a cost system that allows the monitoring (and effective reduction) of expenses, in addition to identifying all costs effectively involved in the process of providing health services, in the pursuit of its competitive advantage. The use of different cost analysis methodologies (Absorption Costing, Activity Based Costing (ABC) and the Contribution Margin approach) were analyzed in the case organizations. Reinforcing the analysis of the activity through the Value Chain prism, the results obtained in the case organizations that used one or more than one methodology for cost analysis, determined the main bases for decision making by the manager. A concrete fact common to any of these methodologies and the impact on hospitals and their activities is that, by knowing the true costs of the services provided, these health organizations will be in a position to cut waste, improve their services, evaluate quality incentives and empower yourself for continuous improvement. Thus, it is noteworthy that this research identifies and analyzes relevant issues for the management of a health organization, focusing on the decision-making process of a strategic nature, based on the integration and analysis of cost information, by involving the decision-making process itself, the structural transformation and management of activities in the value chain, in its technical and administrative-financial aspects, in the hospital organization. The research methodology is exploratory and based on the study of multiple cases.