Implementação de sistema de custos e a usabilidade das informações ; estudo de caso em um Hospital Universitário de Minas Gerais

Abstract

The implementation of a cost management system within the context of the Brazilian Unified Health System (SUS), focused on resource optimization, is crucial to reconcile universal access, comprehensive care, and financial sustainability. In this context, the SUS Cost Calculation and Management System (ApuraSUS) was the solution adopted by a University Hospital in Minas Gerais. The general objective of this investigation was to analyze the process of implementing cost management using the ApuraSUS system and the use of cost information in the institution, and to propose a mechanism to support cost analysis. This study is characterized as qualitative, exploratory, and descriptive research, adopting the case study method. The investigation techniques included in-depth document analysis and semi-structured interviews with sixteen strategic and tactical managers with over two years of hospital management experience. Data analysis was performed using content analysis. The results indicated that the implementation of ApuraSUS enabled more detailed cost calculation; however, it faced challenges due to constant adjustments to standardization from different spheres, demanding continuous alignment efforts. Although managers recognize the strategic importance of cost management for sustainability and quality of care, the effective and systematic use of data is hindered by the fragmentation of information sources across multiple systems and the consequent reliance on a manual process of data collection and consolidation in spreadsheets, generating rework and risks to reliability. To overcome the barrier of usability and disclosure, the study proposed and developed a Cost Management Dashboard in Microsoft Power BI, as a technical product, aiming to transform static reports into an analytical and interactive tool to support decision-making. The research aims to contribute to the theoretical and practical understanding of cost systems in university hospitals, demonstrating that the success of ApuraSUS implementation depends on overcoming data integration challenges and promoting a cultural shift among professionals towards the daily use of information.