Financiamento do SUS paralelo aos gastos na Fundação Hospitalar do Estado de Minas Gerais: um estudo de caso compreensivo fundamentado na base de conhecimento gerada com a metainformação custo

Abstract

The provision of public hospital services is fully funded by the Sistema Único de Saúde (SUS). This study, of exploratory nature, aims to understand the financial transfers from the Federal Government to public and private hospitals providing services to SUS. It is known that the SUS is the largest purchaser of health services, and also highlights the importance that hospitals have in this sector. The study focused on the relationship between the costs and funds transferred reflects, among other indicators, the risk in the sector, particularly the operational risk. The unit of analysis of this research is the Fundação Hospitalar de Minas Gerais - FHEMIG. The study used secondary data collected at the institution, which were opposed to the values passed by the Ministry of Health. The hospital and outpatient procedures responsible for the greatest resources generation in FHEMIG were identified by Pareto and constituted objects of the research study, in the face of transfers from SUS. The 25 (twenty five) researched procedures (five outpatient ones and twenty hospital ones) represent 50% of FHEMIGs revenue, accounting respectively for about 13% of outpatients and 38% passing the hospital SUS. The methodology consisted of quantitative and qualitative approach. The study has developed a quantitative analysis on the measures of operational risk related to the probability of returns shown by the data of costs of hospital procedures in the face of transfers from SUS. On this evaluation method, it was applied as method Value at Risk-VaR. It was identified that 14.6% of the procedures (FHEMIG) have up to 4.8% of costs covered (SUS). However, 72.4% of the procedures (FHEMIG) have a risk cover between 4.8% and 32.9% (SUS). Finally, 12.9% (FHEMIG) have coverage over 32.9% (SUS). The study has concluded that the relationship between "operational cost and SUS table" does not represent a simple or simplistic correlation, unique or exclusive form of transfer of resources, nor cost values represent the only reasons for the values in Table. The non-alignment from "operational costs (FHEMIG) x SUS Table," as evidenced quantitatively, were also considered in order embodied in qualitative data analysis, through interviews and content analysis. It was concluded by the need not only to deepen the composition of the amount of resources transferred to hospitals, but also for reasons of payments information costs of public hospitals from SUS and also review the forms of payment to providers based on cost.