应用 TDABC 评估妇科肿瘤领域检查的盈利能力和计算机断层扫描的闲置程度

Helcio Mendonça Pereira, Rodney Wernke, Cleyton De Oliveira Ritta
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摘要

妇科恶性肿瘤是导致妇女死亡的主要因素之一,影像检查是诊断、分期和手术规划的重要工具。此类检查在影像诊断中心(CDI)进行,由于需要使用先进的技术和合格的劳动力,因此费用昂贵,并对医疗系统造成影响。有鉴于此,本研究旨在展示如何利用 TDABC 评估妇科肿瘤单位计算机断层扫描部门的检查收益和闲置程度。为此,我们采用了定性和描述性方法,并采用了案例研究的形式,通过文献研究、非正式访谈来收集数据,以了解流程和活动执行时间的估算。结果表明,由于提供这些服务的成本高于统一卫生系统(SUS)支付的价格,因此所进行的检查存在缺陷,导致当月共损失 79 347.04 雷亚尔。此外,还确定了相关活动的闲置程度,既包括闲置分钟数,也包括货币价值。因此,得出的结论是,所调查的断层摄影部门的总闲置时间达到 102 932.81 雷亚尔,相当于所涉及活动的平均 41.62%(在设备方面为 3.66%,在护士活动方面为 81.59%)。关于所做的贡献,值得注意的是,TDABC 提供的信息可以支持旨在缩短活动间隔时间和优化相关员工绩效的行动,此外还可以证明 TDABC 在提供诊断成像服务的实体范围内的遵守情况。从获得的结果中可以得出结论,必须优化流程,缩短检查时间,提高生产率,同时需要重新调整 SUS 表中的数值,以避免影响医院其他部门的资源投入。
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Application of TDABC in assessing the profitability of examinations and the level of idleness of computed tomography in the gynecological oncology sector
Gynecological malignancies represent one of the main mortality factors in women, with imaging exams being important tools for diagnosis, staging and surgical planning. Such exams are carried out at Diagnostic Imaging Centers (CDI) which, due to the use of sophisticated technology and qualified labor, are expensive and impact health systems. Given this context, this research aims to demonstrate how TDABC can be used to evaluate the profitability of exams and the levels of idleness that exist in the context of the computed tomography sector of the gynecological oncology unit. For this purpose, a methodology classifiable as qualitative and descriptive was used and the case study format was adopted, with data collection through documentary research, informal interviews to learn about the process and estimates of the execution time of the activities. The results showed that the tests carried out are deficient, as the cost of providing these services is higher than the prices paid by the Unified Health System (SUS), which resulted in a total loss of R$ -79,347.04 in the month. The levels of idleness of the activities involved were also determined, both in terms of inactive minutes and in monetary values. Therefore, it was concluded that the total idleness of the tomography sector surveyed reached R$ 102,932.81 and is equivalent to 41.62% on average for the activities covered (varying between 3.66% in the case of equipment and 81.59% in relation to nurses’ activity). Regarding the contributions made, it is worth noting that the information made available by TDABC can support actions aimed at reducing time between activities and optimizing the performance of the employees involved, in addition to demonstrating TDABC's adherence within the scope of entities that perform diagnostic imaging services. From the results obtained, it is concluded that it is essential to optimize processes to reduce exam time and increase productivity, as well as the need to readjust the values in the SUS table to avoid compromising investment of resources in other sectors of the hospital.
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