Sistemas de custeio na gestão hospitalar

The cost management in any organization provides a number of benefits such as security in the good management of resources, but it is little used in the public hospital sector which is shaped like a paradox, facing the complexity of hospital organization and the underfunding situation of Cheers. The purpose of this book was to develop and submit an application method of a costing system in public hospitals. This proposal was developed in partnership with the Secretariat of the State of Paraná Health, with financial support from PPSUS and Araucaria Foundation. The study was conducted as an action research in two public hospitals in Paraná, but it can be replicated in any hospital from the premises of the developed method. For this, We developed the concepts of administration and public governance, the right to health in Brazil, the costs in the public sector and the detailed presentation of the proposed costing system model. The results constitute an important management tool for hospitals and Ministry of Health, enabling greater security leaders in the face of difficulties and challenges in this segment. Thus, it is expected that the book will contribute to governments for better management of public funds allocated to health; with academia, as a still incipient theme in literature; and society, so that more hospitals were professionalize its cost management and thereby provide a more efficient and effective service.

Estudo de caso: minimização e reúso de água em shopping center da região sul do Brasil

The main issues related to water conservation in urban centers are the increase in water supply cost, demand growth, pollution and differences in the distribution of water resources. Water conservation, the controlled and efficient use of water, includes both measures as reasonable means of water reuse. Thus, conservation practices are an effective way to meet demand and supply water to new activities and users without jeopardizing the supplying water bodies and preserving the natural environment. This study aims to examine the water management of a shopping mall and the use of rainwater harvesting combined with greywater reuse. For buildings in general, water loss is common due to leaks in the hydraulic and restroom equipment. These losses, which are caused by a high volume of water used and wasted in the system, are often the result of design errors, incorrect maintenance procedures and users' bad habits In southern Brazil, where there is rainfall almost all year long, water shortages occasionally occur, particularly in some winter mouths. One difficulty that appears on rainwater studies is the proper determination of rainwater volume that can be used to address water supply systems. In this work, the simulation method was used to determine this volume. Thus, simulations with the following variables: rainfall, catchment area and water consumption were performed. For mall's hydraulic systems, segmented alternatives are adopted. That is, focusing on the use of rainwater or greywater reuse. Other alternatives of effluent reuse have been slightly discussed due to sanitary issues, those are effluents from toilets and kitchen sinks. The adoption of greywater may be feasible if there is a significant flow of greywater to comply water demand for toilet flushing. The inspections made in this study found that the quantity of sinks was insufficient to supply an adequate amount of water to toilets and urinals. The greywater reuse system was found to be infeasible in terms of demand and supply of water. Conversely, the rainwater harvesting system was entirely feasible and easily supplied water to all restrooms and contributed to the cooling of the air conditioning system with a short payback period. One of the challenges of this work was the need to compare the actual water consumption with a water consumption parameter used in buildings. Thus, a method that addresses the generation of specific consumption indexes for specific activity (like a mall) was used. The water consumption indices showed that this mall has a satisfactory water management program.