Proposal of a route to help the manager in the process of monitoring the billing in the urgency/emergency and hospital interment sectors in the Single Health System

Autor: Mathias, Denise
Přispěvatelé: Rached, Chennyfer Dobbins Abi, Liberal, M??rcia Mello Costa de, Novaretti, Marcia Cristina Zago, Soarez, Patr??cia Coelho de, Bittar, Olimpio Jose Nogueira Viana
Jazyk: portugalština
Rok vydání: 2016
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da Uninove
Universidade Nove de Julho (UNINOVE)
instacron:UNINOVE
Popis: Submitted by Nadir Basilio (nadirsb@uninove.br) on 2017-01-26T16:50:06Z No. of bitstreams: 1 Denise Mathias.pdf: 1924270 bytes, checksum: 1900fdbe1184fceb35832b8db907ba1e (MD5) Made available in DSpace on 2017-01-26T16:50:06Z (GMT). No. of bitstreams: 1 Denise Mathias.pdf: 1924270 bytes, checksum: 1900fdbe1184fceb35832b8db907ba1e (MD5) Previous issue date: 2016-12-06 The Brazilian public hospital billing is composed of different non-integrated systems, which hinders the accuracy of the obtained data, and consequently the work of the managers on this area in guaranteeing a precise billing that correctly reflects the given assistance. The objective of this work was to construct a tool that helps in the monitoring of the accuracy of some essential procedures to be included in the database of the Walk In Care Information System and a verification script for the registry of executed procedures on the medical records and that should be posted to the Hospital Information System, in order to mitigate risks of nonconformity of information. The tool was implemented in the S??o Mateus Pronto Care ( Walk In Care ? ) facility, part of the network of units under management of the Municipal Hospital Autarquia, as this facility presented the largest discrepancy between the quantity and approved value. After that it was extended to another 36 Walk In Care units of all sizes. The results were analyzed based on the referenced values from Table of Procedures, Medications, Orthotics, Prostheses and Special Materials-OPM (SIGTAP). The research provided the identification of interference factors in the process of coding and recording care that compromised the accuracy of the database in the Outpatient Information System. The proposed tool contributed to the accuracy of the registry, the comparative analysis between the 1st quarter of 2009 and the 1st quarter of 2010, evidencing a difference of 5.2 times lower in the average value of the medical procedure. The proposed script, using the variable value of the daily rate and length of stay for the treatment of pneumonia or influenza (flu), compared to the same variables of the SIGTAP, evidenced the increase of the daily value from 75% to 84% in relation to the reference. O faturamento hospitalar p??blico brasileiro ?? composto por diferentes sistemas n??o integrados, o que dificulta a acur??cia dos dados obtidos, e consequentemente o trabalho dos gestores desta ??rea em garantir um faturamento preciso que traduza a assist??ncia, o objetivo deste trabalho foi construir um instrumento que auxilie no monitoramento da exatid??o de alguns procedimentos essenciais de constarem na base de dados do Sistema de Informa????o Ambulatorial e um roteiro de verifica????o do registro de procedimentos constantes no prontu??rio de cl??nica m??dica e que devem ser lan??ados no Sistema de Informa????o Hospitalar, visando mitigar riscos de inconformidade da informa????o. O instrumento foi aplicado no estabelecimento Pronto Atendimento S??o Mateus, integrante da rede de unidades sob gest??o da Autarquia Hospitalar Municipal, por ser o que apresentava a maior discrep??ncia entre a quantidade e valor aprovado, posteriormente foi estendido para o universo de 36 unidades, de pequeno a grande porte. Os resultados foram analisados a partir dos valores referenciados na Tabela de Procedimentos, Medicamentos, ??rteses, Pr??teses e Materiais Especiais-OPM (SIGTAP). A pesquisa proporcionou a identifica????o de fatores de interfer??ncia no processo de codifica????o e registro da assist??ncia que comprometiam a acur??cia da base de dados no Sistema de Informa????o Ambulatorial. O instrumento proposto contribuiu com a precis??o do registro, a an??lise comparativa entre o 1?? trimestre de 2009 e o 1?? trimestre de 2010, evidenciou diferen??a de 5,2 vezes a menor no valor m??dio do procedimento. O roteiro proposto, utilizando a v??ri??vel valor da di??ria e tempo de perman??ncia para o tratamento de pneumonias ou influenza (gripe), comparado ??s mesmas vari??veis do SIGTAP, evidenciou a eleva????o do valor da di??ria de 75% para 84% em rela????o ?? refer??ncia.
Databáze: OpenAIRE
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