Analysis of hospital costs: a case study of elective cesarean section in a private maternity in a private maternity in northeast Brazil using the Time-Driven Activity-Based Costing (TDABC) methodology
DOI:
https://doi.org/10.33448/rsd-v13i8.46571Keywords:
Cost; Time; Cesarean.Abstract
Introduction: Cesarean birth is a surgical procedure used to deliver a fetus through the abdominal route rather than vaginally. In Brazil, this procedure can be carried out by request of the pregnant woman, known as an elective cesarean. Our aim was to estimate the average cost of an elective cesarean section using the micro costing technique with the TDABC methodology. Methodology: This descriptive case study utilized the eight-step technique for the TDABC methodology. The study involved interviews, field analysis, review of medical records and cost spreadsheets, as well as the calculation of the cost capacity rate (CCR) in Excel spreadsheets. Numerical variables were analyzed using averages and categorical variables using percentages. Results and Discussion: The study determined an average cost of R$1,400.51 reais per cesarean procedure. Based on the exchange rate, this cost can be estimated at $273.53 dollars or €256.03 euros. Final Consideration: The analysis allowed for comparison with previous studies and highlighted the disparity and relative cost containment in our reality. It also contributed to the pricing of packages when contracts are reviewed.
References
Blanski MBS et al. (2015). Sistemas de custeio na gestão hospitalar. UTFPR.https://repositorio.utfpr.edu.br/jspui/bitstream/1/1600/6/custeiogestaohospitalar.pdf
Cabral, P. H. D., Neto, C. V., & Souza, Â. R. L. de. (2021). Time-driven activity-based costing (TDABC): Uma revisão sistemática da literatura. Anais do Congresso Brasileiro de Custos - ABC. https://anaiscbc.emnuvens.com.br/anais/article/view/4866
Carnielo MT. (2018). Gestão de custos hospitalares por meio do DRG. Em DRG Brasil: Transformando o sistema de saúde brasileiro e a vida das pessoas (1o ed, Vol. 1, p. 454). ePub.
da Silva Etges, A. P. B. et al.(2019). An 8-step framework for implementing time-driven activity-based costing in healthcare studies. The European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care, 20(8), 1133–1145. https://doi.org/10.1007/s10198-019-01085-8
Dubron, K., Verschaeve, M., & Roodhooft, F. (2021). A time-driven activity-based costing approach for identifying variability in costs of childbirth between and within types of delivery. BMC Pregnancy and Childbirth, 21(1), 705. https://doi.org/10.1186/s12884-021-04134-4
Entringer, A. P., Pinto, M. F. T., & Gomes, M. A. de S. M. (2019). Análise de custos da atenção hospitalar ao parto vaginal e à cesariana eletiva para gestantes de risco habitual no Sistema Único de Saúde. Ciência & Saúde Coletiva, 24, 1527–1536. https://doi.org/10.1590/1413-81232018244.06962017
Estrela C. (2018). Metodologia Científica: Ciência, Ensino, Pesquisa. Artes Medicas.
Etges, A. P. B. da S., Ruschel, K. B., Polanczyk, C. A., & Urman, R. D. (2020). Advances in Value-Based Healthcare by the Application of Time-Driven Activity-Based Costing for Inpatient Management: A Systematic Review. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 23(6), 812–823. https://doi.org/10.1016/j.jval.2020.02.004
Etges, A. P. B. da S. et al.(2021). Custos com os cuidados da atrofia muscular espinhal 5q (AME-5q) no Brasil. J. bras. econ. saúde (Impr.). http://antigo.jbes.com.br/images/v13n2/145.pdf
Etges, A., Schlatter, R., Neyeloff, J., Araujo, D., Bahia, L., Cruz, L., Godoy, M., Bittencourt, O., Rosa, P., & Polanczyk, C. (2019). Estudos de Microcusteio aplicados a avaliações econômicas em saúde: Uma proposta metodológica para o Brasil. Jornal Brasileiro de Economia da Saúde, 11, 87–95. https://doi.org/10.21115/JBES.v11.n1.p87-95
Kaplan, R. S., & Porter, M. E. (2011). How to solve the cost crisis in health care. Harvard Business Review, 89(9), 46–52, 54, 56-61 passim.
Kaplan RS, S. R. (2007). Time-Driven Activity-Based Costing: A Simpler and More Powerful Path to Higher Profits—Book—Faculty & Research—Harvard Business School (1o ed, Vol. 1). Harvard Business School Publishing Corporation.
Keel, G., Savage, C., Rafiq, M., & Mazzocato, P. (2017). Time-driven activity-based costing in health care: A systematic review of the literature. Health Policy (Amsterdam, Netherlands), 121(7), 755–763. https://doi.org/10.1016/j.healthpol.2017.04.013
Limaverde, D. F., Souza, L. P. de, & Khamis, R. B. M. (2023). A cesárea eletiva no SUS e os princípios da isonomia e da liberdade de escolha: Exame da constitucionalidade do § 8o do art. 8o do ECA. Unisanta Law and Social Science, 12(1), Artigo 1.
Michels, A., Sott, V. R., Klaus, M., & Palu, T. P. (2018). Custos de um centro obstétrico: estudo de caso em um hospital regional do extremo oeste catarinense. Anais do Congresso Brasileiro de Custos - ABC. https://anaiscbc.emnuvens.com.br/anais/article/view/4493
Odhiambo, J. et al.(2019). Health Facility Cost of Cesarean Delivery at a Rural District Hospital in Rwanda Using Time-Driven Activity-Based Costing. Maternal and Child Health Journal, 23(5), 613–622. https://doi.org/10.1007/s10995-018-2674-z
Pereira A.S. et. al. (2018). Metodologia de pesquisa científica. Artes Médicas.
Porter, M. E. (2010). What is value in health care? The New England Journal of Medicine, 363(26), 2477–2481. https://doi.org/10.1056/NEJMp1011024
Velho, M. B., Santos, E. K. A. D., & Collaço, V. S. (2014). Natural childbirth and cesarean section: Social representations of women who experienced them. Revista Brasileira de Enfermagem, 67(2). https://doi.org/10.5935/0034-7167.20140038
Yin, R. K., & Herrera, C. M. (2015). Estudo de caso: Planejamento e métodos (5a ed). Bookman.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Marcos Alves Pavione
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.