Publications IPH Magazine Annals of Summaries: 38th Congress of Hospital Administration and Health Management Interview with Scientific Coordinator of the Congress for Cost and Financial Management

The Congress for Cost and Financial Management was held during an unfortunate economic situation, with negative growth of the GDP, high inflation, devalued currency and skyrocketing interest rates. This unfavorable scenario affects negatively all the connections along the health chain, causing health service resources to plummet and, at the same time, the increase of its costs. We discussed the consequences of this scenario for the area, what must be done to lessen its effects and how to improve our hospital's level of efficiency having Information Technology at our side. We also approached the impact of the legislation that allowed foreigner capital into our hospitals and how Brazilian hospitals must prepare to face this new challenge. As we often do in our Congress, we presented some successful cases concerning the adoption of indexes as a management tool. We also had two specialists presenting two tools to support the management of the clinic body, about which hospitals are beginning to show interest: DRG and Payment for Performance. Finally, we brought two panels concerning the Unimed System that plays an important role at the Brazilian supplementary health: the first one was presented by one of the creators of the movement of having its own resources, analyzing its results and challenges. The second one presented a successful experience of a new model of management in a medical cooperative in the countryside of São Paulo. 

Considering the economic scenario, I believe that right now the most relevant issue is for hospital managers to understand this situation, assess its impact for their organizations and plan which actions must be taken in order to seek out indoors resources through the improvement of efficiency and productivity in every area of the hospital: assistance, support and management. A thorough reexamination of processes combined with computerization and automation is also part of the project that aims at generating resources through internal savings that can be obtained by eradicating do-over and wastes. There is another issue worth mentioning concerning supplementary health: changing the relationship between service providers and health insurance companies. A relationship surrounded by intense conflict that should change into a model that considers both activities complementary, aiming at best serving clients/patients. I'm certain that an agreement will be fundamental to maintain the sustainability of the industry.

Even though the last years have seen an effort to make the financial area of hospitals more professional by hiring professionals from other areas of expertise, we have noticed in our national consultancy that this effort is still uneven, since small and medium size hospitals still have an almost amateur style of management. To give you an example: most Brazilian hospitals are unaware of the costs concerning their operations and procedures, since they haven't set an investigation and cost management systems. And this is basic information to manage any entrepreneurial activity. How can I establish my prices if I don't know how much my services and products cost? How to decide which services or specialties the hospital must prioritize if I don't know their outcomes? Therefore, the effort towards management improvement must be even more prioritized in this unfavorable economic moment that the country is going through with little perspective of improvement in the medium term.