Análise de desempenho de organizações hospitalares

• Ano de defesa: 2010
• Autor(a) principal: Mariana Guerra
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Modelo DEA; SIH-SUS; Indicadores financeiros; Gestão financeira; Indicadores operacionais; SIA-SUS; Hospitais Finanças; Administração financeira
• Link de acesso: http://hdl.handle.net/1843/BUOS-8KZNFA

Despite displaying a predominant importance in the health system in Brazil, few studies elaborating on the national assessment of hospitals, mainly on the analysis of financial indicators that can guide the policy makers in the country. Moreover, few international studies focus on the analysis of health services organizations (LA FORGE; COUTTOLENC, 2009). In general, beyond the difficulties inherent of these organizations specifics, studies have shown that the absence of reliable information about quality, efficiency and costs of hospital care is a major problem in hospitals and hampering efforts to improve efficiency in the provision of services. Given this context, this study focuses on financial management for hospitals, which can be translated into two research questions, namely: (i) what factors determine the efficiency of hospitals? (ii) as to the efficiency rates vary among hospitals of different types and sizes? To this end, the objective of this study was to analyze the efficiency of hospitals from financial and nonfinancial indicators, in order to show the (in) efficiency of the financial management of hospitals public and private (profit and non-profit). Among the results presented, there is a proposed framework for assessing the efficiency of the hospitals financial management. Consisting of thirteen models that use the method of Data Envelopment Analysis (DEA), the proposal includes both financial and operational indicators for calculating the efficiency of the hospitals studied. By means of selected indicators from the last six of these models, it was proposed a standard model, composed of the most important variables and can therefore determine the efficiency of the hospitals analyzed. It is noted that a total of 72 hospitals contracted by the Sistema Único de Saúde (SUS), 26 organizations were selected for analysis, mainly due to the availability of access to financial statements - which should be publicly disclosed and, in particular via the Internet - and the data from the SUS Hospital Information System (SIH-SUS) and the SUS Ambulatory Information System (SIA-SUS). The indicators considered in the formulations of the models were (i) financial - PCT, LC, TMP, GA, MO, ROA and End, (ii) operational - TO, TMP, LO, FTE/LO. The relations between these indicators were based on the authors: (i) Schuhmann (2008) and McCue and Nayar (2009), (ii) Kutzin and Barnum (1993), (iii) Younis, Younio and Okojie (2006); (iv) Marinho, Moreno e Cavalini (2001); (v) Ersoy et al. (1997). From the outputs, it was observed that the financial indicators considered in the study - PCT, LC, PMP, End - in general, presented for the models with the results of these inputs, relevant to determining the efficiency of hospitals. The exception was PMP, which showed no significant weight in the models calculated. For operational indicators - TMP, TO, LO and FTE/LO, we obtained relevant results for the indicators TMP, TO and FTE/LO in some of these models that considered these indicators as inputs. Overall, it was concluded that this work can contribute to the performance analysis of the financial management of hospitals. Firstly, because it shows the relationship of financial and operational indicators that can be used to assess the effectiveness of these organizations. Second, because present values of these indicators can be used as standard for analysis of health sector organizations.