Cost Analysis in Hospitals: Comparing Actual Costs of Urological Procedures and Reimbursement Values paid by the Unified Health System

Abstract

The complexity of hospital organizations requires detailed cost information that reflects activities in the actual hospital environment, so that costs can be traced and properly managed. Consistent cost information is instrumental in allocating scarce resources, especially in hospitals providing health services reimbursed by the Unified Health System (SUS), Brazil's publicly funded health care system. One of the costing methods that can be implemented in hospital cost management is Activity-Based Costing (ABC), a method which, unlike traditional costing systems, allocates overhead costs to services more efficiently. Drawing on this methodology, this paper reports on a case study aimed at assessing whether the values for urological procedures reimbursed by the Unified Health System were sufficient to meet the actual costs incurred in those procedures. More specifically, the research herein reported (i) made use of ABC to calculate the costs of urological procedures in a philanthropic hospital in the city of Belo Horizonte, State of Minas Gerais; (ii) queried the Unified Health System databank (DATASUS) for information on the values paid for the procedures under analysis; and (iii) performed a comparison of actual costs and reimbursement paid by SUS. The results show that the reimbursement values paid failed to meet the costs incurred in urological services, the ABC system revealing a significant discrepancy between reimbursed values and actual costs.