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7.
Cad Saude Publica ; 24(1): 157-68, 2008 Jan.
Article in Portuguese | MEDLINE | ID: mdl-18209844

ABSTRACT

This article describes charitable hospitals in Brazil that provide managed care and the health management organizations themselves, considering the level of autonomy by the latter in relation to the hospitals and their degree of management development, based on a nationwide study. A random sample of individual hospitals was drawn from the hospital groups. After refusals and replacements, the final sample consisted of 112 individual hospitals and 10 hospital groups. The charitable hospitals' managed care plans do no operate precisely according to the overall Brazilian health plan market, in which most of the managed care is situated in insurance companies, group medicine, and medical cooperatives. Rather than operating as typical plans, they function "inside the organization or hospital itself", almost always with a limited management infrastructure and with little autonomy in relation to the organizations harboring them. Individual plans were more common than collective products, unlike the rest of the market, which may also result from the limited management capacity of these arrangements.


Subject(s)
Charities , Health Maintenance Organizations/organization & administration , Hospitals, Voluntary/organization & administration , Insurance, Health , Prepaid Health Plans/organization & administration , Brazil , Delivery of Health Care , Demography , Health Maintenance Organizations/economics , Hospitals, Voluntary/economics , Humans , Insurance Coverage , Insurance, Health/standards , Prepaid Health Plans/economics
10.
Rev Alerg Mex ; 50(3): 103-7, 2003.
Article in Spanish | MEDLINE | ID: mdl-12940110

ABSTRACT

BACKGROUND: Administration of multiple doses of inhaled impratropium bromide and salbutamol represents the first-choice treatment for severe asthmatic crisis. However, there is a scarce evidence demonstrating that this therapeutic intervention in cost-effective. OBJECTIVE: To determine cost-effectiveness relationship related to administration of ipratropium bromide in the treatment of severe asthmatic crisis in adults at two hospitals in Montevideo, Uruguay. MATERIAL AND METHODS: The cost of each treatment was estimated in U$S 0.9 when drug was administered by a metered dose pressurized inhaler (MDI) or U$S 1.7 by using a jet nebulizer (NEB). RESULTS: A monetary saving per patient (considering a median of five days of hospitalization and a risk reduction of 0.17) of U$S 30 with MDI or U$S 29 with NEB was observed in the public practice, and a saving of U$S 78 and 77, respectively in the private practice. The total annual monetary saving was of U$S 3,101 with MDI and U$S 2,897 with NEB in the public practice, and of U$S 4,979 and U$S 4,830 in the private practice. A two-way sensitivity analysis taking into account the length of hospitalizations and the risk reduction did not modify significantly the results. CONCLUSIONS: The treatment of adults with severe acute asthma by using ipratropium bromide results cost-effective, leading to a significant saving of resources.


Subject(s)
Anti-Asthmatic Agents/economics , Asthma/economics , Ipratropium/economics , Acute Disease , Administration, Inhalation , Adult , Anti-Asthmatic Agents/administration & dosage , Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Cost-Benefit Analysis , Drug Costs , Hospital Costs , Hospitalization/economics , Hospitals, Military/economics , Hospitals, Urban/economics , Hospitals, Voluntary/economics , Humans , Ipratropium/administration & dosage , Ipratropium/therapeutic use , Length of Stay/economics , Risk Reduction Behavior , Uruguay
18.
J. bras. med ; 64(3): 63-4, 68, 70, mar. 1993. tab
Article in Portuguese | LILACS | ID: lil-186644

ABSTRACT

Este trabalho tem como objetivo demonstrar que as dificuldades financeiras que atualmente os hospitais filantrópicos privados enfrentam, a exemplo da Santa Casa da Misericórdia de Cachoeiro de Itapemirim (SCMCI), Espírito Santo, instituiçäo considerada pelo Ministério da Saúde em 1991 como padräo pelo seu desempenho nas atividades de controle das infecçöes hospitalares, ocasionam visivelmente uma queda na qualidade do atendimento médico-hospitalar e, consequëntemente, elevaçäo das incidências das infecçöes hospitalares que, fechando um círculo vicioso, elevam os custos das internaçöes hospitalares.


Subject(s)
Humans , Anti-Bacterial Agents/economics , Cross Infection/economics , Length of Stay/economics , Anti-Bacterial Agents/therapeutic use , Hospitals, Voluntary/economics , Incidence , Cross Infection/etiology
19.
s.l; s.n; 1992. <223> p.
Thesis in Portuguese | LILACS | ID: lil-112899

ABSTRACT

Objetivou-se conhecer as metodologias implementadas nos sistemas de apuraçäo de custos e o da utilizaçäo das informaçöes resultantes como instrumentos de gerenciamento hospitalar, foram estudados dois hospitais, um com finalidade lucrativa e outro sem finalidade lucrativa, localizados na cidade de Säo Paulo, Brasil. A pesquisa foi do tipo descritivo e de desenvolvimento metodológico. Os dados foram coletados através da observaçäo direta e de entrevistas semi-estruturadas com funcionários e dirigentes dos estabelecimentos investigados, utilizando-se dois roteiros. Para a determinaçäo dos custos, os hospitais pesquisados fazem uso do custeamento por absorçäo, obtendo um valor médio para os diferentes serviços prestados. As metodologias para a apuraçäo dos custos em ambas as instituiçöes é a da reduçäo escalar ou "step-down", similar à proposta pela Associaçäo Americana de Hospitais. No que se refere à utilizaçäo das informaçöes de custos pelas equipes gestoras, esta é limitada a nível do controle administrativo com pouca aplicaçäo nos aspectos estratégicos das instituiçöes


Subject(s)
Costs and Cost Analysis , Data Collection/instrumentation , Financial Management, Hospital , Brazil , Hospitals, Voluntary/economics , Hospitals, Private/economics , Interviews as Topic
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