Cost management applied to public university hospitals: the experience of the The Ribeirão Preto Medical School Clinics Hospital of the University of São Paulo

Abstract

This paper presents the experience of implementing the methodology of cost-based activities (ABC) at The Ribeirão Preto Medical School Clinics Hospital of the University of São Paulo (HCFMRP-USP), through a case study over a period of five years. Characteristics of high technology university hospitals, such as teaching and assistance, make their costs higher than those of non-university hospitals. In its institutional history, HCFMRP-USP lacked a consistent methodology for measuring and assessing the costs of its assistance activities. However, difficulties in financing these activities, associated with a complete restructuring in the hospital’s healthcare model linked to the National Health System, have furthered the adoption of cost mapping, in order to assess adequately the impact of teaching activities in healthcare costs, considering that the country’s democratic agenda has demanded transparency, accountability and, above all, efficiency in public funds management.