português

Abstract

Introduction: The National Cost Management Program (PNGC) was created by the Brazilian Ministry of Health, with the objective of promoting cost management in public health, adopting the absorption costing method. Even though it is a free tool, of the 41 hospitals that are part of the Brazilian Hospital Services Company (EBSERH), only 11 had signed up to the PNGC by August 2022. Objective: To analyze the factors that interfere with adherence to the National Cost Management Program in EBSERH network hospitals. Material and Methods: Descriptive and exploratory field study with a quantitative and qualitative approach (content analysis) based on the responses obtained from 33 of the 38 heads of accounting sectors (SCONT) within the scope of EBSERH. The Microsoft Forms platform was used, where the data collection instrument was made available from September 11, 2023 to October 13, 2023. Results: 87.9% of respondents are senior managers in the respective sector, 81.8% They have been in the role for over a year, 75.8% have specialization as their highest qualification. 42.42% declared that the hospital to which they are linked voluntarily joined the PNGC, while 57.58% declared voluntary non-adherence. The main difficulties reported when voluntarily joining the PNGC were related to the lack of accurate and reliable data, the need for financial and operational resources, ApuraSUS itself and the PNGC and resistance to organizational change. The main results reported after joining the PNGC are related to improving the quality of services provided, increasing operational efficiency, data-based decision making and the financial sustainability of the university hospital. Conclusion: To encourage adherence to the PNGC, we suggest measures that involve: dissemination and training, improvements to the tool, implementation of incentives and awards and institutionalization of the PNGC.