Estimativa de custos dos exames coloração de Gram e hemocultura no serviço de microbiologia de um hospital público federal

Abstract

Establishing and controlling hospital costs is a necessity for any healthcare organizations. Unfortunately, most are unaware of the costs of carrying out laboratory tests, especially in public hospitals of the Brazilian Health System (SUS). The main objective of the present study was to estimate the direct and indirect costs of the Gram Coloring and blood culture exams, from the lab collection to the release of the results, performed at the Microbiology Service of the Clinical Pathology Laboratory Unit of the Clinical Hospital of the Federal University of Minas Gerais. The application of the system "Activity-Based Costing" (ABC) was conducted in five stages: Step 1 - Identification and definition of primary and secondary activities; Step 2 - Survey of the costs of the activities resources; Step 3 - Identification and definition of cost drivers; Step 4 - the activities costs; Step 5 - costs comparison of each procedure with the amounts currently given to the Unified Health System to the institution. The costs of the Gram exam currently are US$ 6.67. For the blood culture test (per vial) the estimated values currently are US$ 12.15 when negative, US$ 46.50 when positive for Gram-positive bacteria and US$ 46.87 for Gram-negative bacteria, from the group Neisseria sp, Haemophilus sp. or yeast. With regard to the remuneration, the costs were higher than 800%, 300% and 500%, respectively, than the amounts reimbursed by SUS. In conclusion, the estimated costs of the microbiological tests were higher than the cost received by SUS, indicating the need to review of working processes and internal control improvements.