Public financing versus private billing in a public hospital under management of a Social Health Organization
ABSTRACT Introduction: to assess the efficiency of management by a Social Health Organization (Organização Social de Saúde - OSS) compared with the private sector; to verify if there are savings for the State Health Secretariat (SES) in management contracts for financing the production of a public...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgiões
2021-06-01
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| Series: | Revista do Colégio Brasileiro de Cirurgiões |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912021000100221&tlng=en |
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| author | NACIME SALOMÃO MANSUR PATRICIA TOSIRO MARCOS DEYVID FERNANDO MATTEI GASPAR JESUS LOPES FILHO |
| author_facet | NACIME SALOMÃO MANSUR PATRICIA TOSIRO MARCOS DEYVID FERNANDO MATTEI GASPAR JESUS LOPES FILHO |
| author_sort | NACIME SALOMÃO MANSUR |
| collection | DOAJ |
| description | ABSTRACT Introduction: to assess the efficiency of management by a Social Health Organization (Organização Social de Saúde - OSS) compared with the private sector; to verify if there are savings for the State Health Secretariat (SES) in management contracts for financing the production of a public hospital versus its production values billed by private methods; and to establish if the amounts billed by the Unified Health System (SUS) table would finance the same procedures. Methods: we compiled and tabulated all procedures performed and the materials and drugs dispensed in the Euryclides Jesus Zerbini Transplant Hospital (HTEJZ), managed by the OSS Associação Paulista Para o Desenvolvimento da Medicina (SPDM), in September, October, and November 2018, according to the Brasíndice® table for drugs, the Simpro® table for materials, the CBHPM® table for medical fees, and tables SIGTAP SUS and SIA SUS. We then compared the average values obtained in the private billing with the costing amount reimbursed by the State Health Secretariat and the billing calculated in the SIA-SUS. Results: the average SUS revenue was R$ 2,774,086.91; the monthly reimbursement by the SES was R$ 13,055,700.00; and the average private revenue was R$ 25,084,440.31. Conclusions: the management by the OSS SPDM in the Euryclides de Jesus Zerbini Transplant Hospital was more efficient in the financing / production ratio than it would be to a private hospital. The economy of public funds was significant. The current SUS table reimbursement values would not meet the need for funding for an overly complex hospital. |
| first_indexed | 2024-12-20T15:04:34Z |
| format | Article |
| id | doaj.art-6cf4456448ad40e989ee7ddb3a0502aa |
| institution | Directory Open Access Journal |
| issn | 1809-4546 |
| language | English |
| last_indexed | 2024-12-20T15:04:34Z |
| publishDate | 2021-06-01 |
| publisher | Colégio Brasileiro de Cirurgiões |
| record_format | Article |
| series | Revista do Colégio Brasileiro de Cirurgiões |
| spelling | doaj.art-6cf4456448ad40e989ee7ddb3a0502aa2022-12-21T19:36:34ZengColégio Brasileiro de CirurgiõesRevista do Colégio Brasileiro de Cirurgiões1809-45462021-06-014810.1590/0100-6991e-20202840Public financing versus private billing in a public hospital under management of a Social Health OrganizationNACIME SALOMÃO MANSURhttps://orcid.org/0000-0002-9582-0946PATRICIA TOSIRO MARCOSDEYVID FERNANDO MATTEIhttps://orcid.org/0000-0002-7862-3908GASPAR JESUS LOPES FILHOhttps://orcid.org/0000-0002-9344-6479ABSTRACT Introduction: to assess the efficiency of management by a Social Health Organization (Organização Social de Saúde - OSS) compared with the private sector; to verify if there are savings for the State Health Secretariat (SES) in management contracts for financing the production of a public hospital versus its production values billed by private methods; and to establish if the amounts billed by the Unified Health System (SUS) table would finance the same procedures. Methods: we compiled and tabulated all procedures performed and the materials and drugs dispensed in the Euryclides Jesus Zerbini Transplant Hospital (HTEJZ), managed by the OSS Associação Paulista Para o Desenvolvimento da Medicina (SPDM), in September, October, and November 2018, according to the Brasíndice® table for drugs, the Simpro® table for materials, the CBHPM® table for medical fees, and tables SIGTAP SUS and SIA SUS. We then compared the average values obtained in the private billing with the costing amount reimbursed by the State Health Secretariat and the billing calculated in the SIA-SUS. Results: the average SUS revenue was R$ 2,774,086.91; the monthly reimbursement by the SES was R$ 13,055,700.00; and the average private revenue was R$ 25,084,440.31. Conclusions: the management by the OSS SPDM in the Euryclides de Jesus Zerbini Transplant Hospital was more efficient in the financing / production ratio than it would be to a private hospital. The economy of public funds was significant. The current SUS table reimbursement values would not meet the need for funding for an overly complex hospital.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912021000100221&tlng=enPublic HealthHealthcare FinancingSocial OrganizationEfficiencyBilling |
| spellingShingle | NACIME SALOMÃO MANSUR PATRICIA TOSIRO MARCOS DEYVID FERNANDO MATTEI GASPAR JESUS LOPES FILHO Public financing versus private billing in a public hospital under management of a Social Health Organization Revista do Colégio Brasileiro de Cirurgiões Public Health Healthcare Financing Social Organization Efficiency Billing |
| title | Public financing versus private billing in a public hospital under management of a Social Health Organization |
| title_full | Public financing versus private billing in a public hospital under management of a Social Health Organization |
| title_fullStr | Public financing versus private billing in a public hospital under management of a Social Health Organization |
| title_full_unstemmed | Public financing versus private billing in a public hospital under management of a Social Health Organization |
| title_short | Public financing versus private billing in a public hospital under management of a Social Health Organization |
| title_sort | public financing versus private billing in a public hospital under management of a social health organization |
| topic | Public Health Healthcare Financing Social Organization Efficiency Billing |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912021000100221&tlng=en |
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