Abstract
to assess the efficiency of management by a Social Health Organization (Organização Social de Saúde - OSS) compared with the private sector; to verify if there are savings for the State Health Secretariat (SES) in management contracts for financing the production of a public hospital versus its production values billed by private methods; and to establish if the amounts billed by the Unified Health System (SUS) table would finance the same procedures. we compiled and tabulated all procedures performed and the materials and drugs dispensed in the Euryclides Jesus Zerbini Transplant Hospital (HTEJZ), managed by the OSS Associação Paulista Para o Desenvolvimento da Medicina (SPDM), in September, October, and November 2018, according to the Brasíndice® table for drugs, the Simpro® table for materials, the CBHPM® table for medical fees, and tables SIGTAP SUS and SIA SUS. We then compared the average values obtained in the private billing with the costing amount reimbursed by the State Health Secretariat and the billing calculated in the SIA-SUS. the average SUS revenue was R$ 2,774,086.91; the monthly reimbursement by the SES was R$ 13,055,700.00; and the average private revenue was R$ 25,084,440.31. the management by the OSS SPDM in the Euryclides de Jesus Zerbini Transplant Hospital was more efficient in the financing / production ratio than it would be to a private hospital. The economy of public funds was significant. The current SUS table reimbursement values would not meet the need for funding for an overly complex hospital.
Highlights
Since the emergence of Social Health Organizations (OSS) in Brazil at the end of the 90s, there has been a debate about the greater efficiency of this management model for public hospitals, when compared with the direct administration, whether municipal, state or federal[1,2,3,4].Miscellaneous published studies demonstrated that public state hospitals in São Paulo managed by Organização Social de Saúde (OSS) produced much more and with higher quality than the corresponding units under direct administration with the same budget, more efficiently[5,6,7,8,9,10,11]
1 - Associação Paulista para o Desenvolvimento da Medicina, Hospital de Transplantes Euryclides de Jesus Zerbini - São Paulo - SP - Brasil Rev Col Bras Cir 48:e20202840. Would it correspond to the SUS financing federal pact? Among the OSS in the State of São Paulo, the Associação Paulista para o Desenvolvimento da Medicina (SPDM) is the one that manages the largest number of units, both state and municipal
Formed in 1933, by a group of teachers and students as a non-profit civil society with the goal of creating and maintaining the Escola Paulista de Medicina (EPM), this association is responsible for the founding and maintenance of the Hospital São Paulo, a university hospital that, after the federalization of the EPM in 1956, continued to belong to the SPDM, which has EPM professors in the Administrative Council
Summary
Since the emergence of Social Health Organizations (OSS) in Brazil at the end of the 90s, there has been a debate about the greater efficiency of this management model for public hospitals, when compared with the direct administration, whether municipal, state or federal[1,2,3,4].Miscellaneous published studies demonstrated that public state hospitals in São Paulo managed by OSS produced much more and with higher quality than the corresponding units under direct administration with the same budget, more efficiently[5,6,7,8,9,10,11]. Since the emergence of Social Health Organizations (OSS) in Brazil at the end of the 90s, there has been a debate about the greater efficiency of this management model for public hospitals, when compared with the direct administration, whether municipal, state or federal[1,2,3,4]. 1 - Associação Paulista para o Desenvolvimento da Medicina, Hospital de Transplantes Euryclides de Jesus Zerbini - São Paulo - SP - Brasil Rev Col Bras Cir 48:e20202840. Would it correspond to the SUS financing federal pact? Recognized as a Social Health Organization in 1998, it manages state and municipal public hospitals through contractual agreements
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