Avaliação dos custos de materiais e medicamentos nas diárias de uma UTI adulto conforme três diferentes modelos de remuneração

Resumo

The ICU (Intensive Care Unit) is a hospital unit for critically ill patients who require intensive care 24 hours per day, with a specialized team composed of professionals from different areas. It is a high-cost unit for implementation and maintenance; therefore, health service providers seek alternatives to reduce costs, without jeopardizing the quality of care provided. Therefore, this dissertation sought to evaluate the average daily costs of medical materials and drugs used in the same ICU that has three reimbursement models - Capitation, Global Daily Room Rate and Fee For Service–, in addition to correlating six (6) independent variables (admission, outcome, age, length of stay, severity and use of mechanical ventilation) determining the influence of each of them on cost. The results of the analysis of the sample of all the data made available for study (total sample) indicated that the global daily room rate reimbursement model had an average daily cost of medical materials and drugs from 2% to 31.69% lower than the Fee For Service model. To confirm the result, a statistical test was performed, which indicated that there was no statistical difference in the total sample, which contradicted the hypothesis formulated for greater control over the use of medical materials and medicines in the global daily room rate model in relation to the Fee For Service. A second statistical test was performed with a sample of the data made available for the study with removal of extreme daily average cost values (outliers). In this sample without outliers, the hypothesis of control in the use of materials and medicines was confirmed. The average daily cost of materials and medicines of the Global Daily Room rate model was 6,1% to 20,8% lower than the Fee for Service, and the samples of the two models have patients with similar age, severity and average length of stay. The Capitation remuneration model presented a higher average daily cost in all cuts of the study due to the specificity of its sample.

Ficha do documento

Tipo

Dissertação

Ano

2021

Instituição

Fundação Getulio Vargas

Fonte

Repositório da FGV

Idioma

Português

Acesso

Acesso aberto

Identificador

oai:repositorio.fgv.br:10438/30733

Temas

Saúde

Palavras-chave

Intensive Care UnitCost of patientCost of treatmentReimbursement modelsPayment modelsUnidade de Terapia IntensivaCusto de pacienteCusto do tratamentoModelos de remuneraçãoModelos de pagamentoAdministração de empresasUnidade de tratamento intensivoCuidados médicos - CustosServiços de saúde