0272/2021 - Micro-Costing of a Remotely Operated Referral Management System to Secondary Care in the Unified Health System in Brazil Microcusteio de um Sistema de Regulação Remoto para o Cuidado Especializado no Sistema Único de Saúde no Brasil
Introdução: O encaminhamento de casos da atenção primária para a secundária no Sistema Único Brasileiro é uma das questões mais importantes a ser enfrentada para permitir a otimização da eficiência do sistema. As estratégias de telessaúde têm se mostrado eficazes para evitar encaminhamentos desnecessários. O objetivo deste estudo foi estimar o custo por caso encaminhado por meio de um sistema de gerenciamento de referenciamentos operado remotamente para subsidiar a tomada de decisão sobre o tema. Métodos: Análise de custo por meio da aplicação de custeio baseado em atividades orientado pelo tempo (time-driven activity-based costing ou TDABC). As análises de custo incluíram comparações entre especialidades médicas, localidades para as quais os encaminhamentos estavam sendo conduzidos e períodos de tempo. Para especialidades médicas e localidades, as diferenças de custo foram exploradas, analisando-se as diferenças no tempo necessário para realizar os encaminhamentos. Resultados: O custo por referenciamento em todas as localidades variou entre R$ 5,70 a R$ 8,29. O custo por referenciamento nas especialidades médicas variou entre R$ 1,85 a R$ 8,56 (mediana = 5,27; IIQ = 3,47 a 7,30). Conclusões: Estratégias para otimizar a gestão dos referenciamentos para a atenção especializada nos sistemas públicos de saúde ainda são necessárias. As estratégias de telessaúde podem ser vantajosas
Palavras-chave:
Encaminhamento e Consulta; Telemedicina; Prestação Integrada de Cuidados de Saúde; Sistema Único de Saúde
Abstract:
Background: Referral of cases from primary to secondary care in the Brazilian public healthcare system is one of the most important issues to be tackled to allow optimized efficiency of the system. Telehealth strategies have been shown effective in avoiding unnecessary referrals. The objective of this study was to estimate cost per referred case by a remotely operated referral management system to further inform the decision making on the topic. Methods: Analysis of cost by applying time-driven activity-based costing. Cost analyses included comparisons between medical specialties, localities for which referrals were being conducted, and periods of time. For medical specialties and localities, differences in cost were explored by analyzing differences in the time needed to perform referrals. Results: Cost per referred case across localities ranged from R$ 5.70 to R$ 8.29. Cost per referred case across medical specialties ranged from R$ 1.85 to R$ 8.56 (median = 5.27, IQR = 3.47 to 7.30). Conclusions: Strategies to optimize the management of referral cases to specialized care in public healthcare systems are still needed. Telehealth strategies may be advantageous, with cost estimates across localities ranging from R$ 5.70 to R$ 8.29, with additional observed variability related to the type of medical specialty.
Keywords:
Referral and Consultation; Telemedicine; Delivery of Health Care, Integrated; Unified Health System
Microcusteio de um Sistema de Regulação Remoto para o Cuidado Especializado no Sistema Único de Saúde no Brasil
Resumo (abstract):
Background: Referral of cases from primary to secondary care in the Brazilian public healthcare system is one of the most important issues to be tackled to allow optimized efficiency of the system. Telehealth strategies have been shown effective in avoiding unnecessary referrals. The objective of this study was to estimate cost per referred case by a remotely operated referral management system to further inform the decision making on the topic. Methods: Analysis of cost by applying time-driven activity-based costing. Cost analyses included comparisons between medical specialties, localities for which referrals were being conducted, and periods of time. For medical specialties and localities, differences in cost were explored by analyzing differences in the time needed to perform referrals. Results: Cost per referred case across localities ranged from R$ 5.70 to R$ 8.29. Cost per referred case across medical specialties ranged from R$ 1.85 to R$ 8.56 (median = 5.27, IQR = 3.47 to 7.30). Conclusions: Strategies to optimize the management of referral cases to specialized care in public healthcare systems are still needed. Telehealth strategies may be advantageous, with cost estimates across localities ranging from R$ 5.70 to R$ 8.29, with additional observed variability related to the type of medical specialty.
Palavras-chave (keywords):
Referral and Consultation; Telemedicine; Delivery of Health Care, Integrated; Unified Health System
Pachito, D. V., Etges, A. P. B. S, de Oliveira, P. R. B. P., Basso, J., Bagattini, A. M., Riera, R., Gehres, L. G., Mallmann, E. de B., Rodrigues, A. S., Gadenz, S.D. Micro-Costing of a Remotely Operated Referral Management System to Secondary Care in the Unified Health System in Brazil. Cien Saude Colet [periódico na internet] (2021/ago). [Citado em 23/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/microcosting-of-a-remotely-operated-referral-management-system-to-secondary-care-in-the-unified-health-system-in-brazil/18171?id=18171
