Uma comparação entre os custos atuais, custos por pacote e reembolso hospitalar para o procedimento de revascularização miocárdica

In Brazil, the supplemental healthcare system is going through a transition period from the traditional Fee-for-service reimbursement system to the Package reimbursement system, similar to the American model known as the Diagnoses Related Groups (DRG) system. Although the Package concept is nothing new to the hospital environment, it is still seldom used since this system calls for a level of control and analytical knowledge of hospital costs that are poorly developed in Brazilian institutions. This study focuses on determining how much the reimbursement for a Myocardial Revascularization Package actually covers of the current costs for patients submitted to this procedure. A prospective analysis method for determining the cost per patient has been developed and 13 patients were individually followed-up during all their hospitalization period. The expenses with intensive care unit and in-patient clinical care, as well as the type of admittance - whether elective or emergency - were determined for each patient. Additionally, all the resources and materials for the surgical procedure were included, comprising specialized personnel, surgical fees, procedures and tests, biomedical equipment, and all the materials and medication used during the hospital stay. Based on this data, the current total costs were calculated and compared to the reimbursement for the Package previously agreed upon by the institution and the healthcare carriers. The study found an average cost of BR$ 8,826 for a Myocardial Revascularization surgical procedure, while the respective reimbursement for the Package is of BR$ 7,476. Therefore, the reimbursement does not cover the current costs of the procedure.

Modelagem de previsões econômicas em cenários prospectivos

A estabilidade econômica que o Brasil atualmente experimenta permite resgatar a tradição de construção e análises prospectivas de médio e longo prazos. Isto remete à necessidade de se pensar mais profundamente acerca da possível evolução da economia brasileira, sendo mister o conhecimento de ferramentas de previsão. O objetivo deste trabalho é contribuir com este propósito. Avanços significativos têm sido observados na modelagem de previsões macro econômicas. Para se avaliar como os modelos de previsão estarão se desenvolvendo no futuro próximo, é necessário entender a evolução das abordagens dos modelos de previsão não-estruturais e estruturais. Como dependem da teoria econômica, os modelos estruturais ganham importância e descaso na medida em que a teoria evolui e cai em desuso. A marca registrada das previsões macroeconômicas nos próximos anos será o casamento das melhores abordagens estruturais e não-estruturais, facilitadas por avanços em técnicas numéricas e de simulação. Para ilustrar o trabalho de forma empírica, três cenários para a economia brasileira foram desenvolvidos, utilizando-se como base o arcabouço teórico resumido em uma das seções deste trabalho. Cenários potencialmente têm um valor muito grande na gestão de uma empresa ou de uma instituição. Cenários são a oitava ferramenta gerencial mais utilizada nas empresas em todo o mundo1 e esta dissertação é mais uma contribuição para este rico campo.

Structural analysis of the place of wine in Brazil

With the constant decrease of the wine consumption in traditional winemaking countries, more and more Brazil is seen as an appealing market. But the country also pretends to become an international player of winemaking in its own right. Both the participants of the Brazilian wine industry and the foreigners trying to get advantage of this promising market are facing new challenges to develop the consumption of wine in the world’s fifth largest country. Among all the possible actions to be taken in that sense, it also is worth taking time for a collective thought on the place of wine in the country, as well as the factors that shape it. What are these factors, which ones really make the difference, and what is their respective impact on the evolution of the place of wine in the country? After drawing the big picture of the wine market situation, this thesis tries to identify the levers of the evolution of the place of wine in Brazil. Using the tools of prospective, it aims at putting into perspective the different driving forces that influence its development, and in particular the relative influence of the political drivers. This paper also intends to be a first step of a prospective study as it constitutes a solid base for scenario planning. This paper is divided in five chapters starting with “introduction”, followed by chapter 2 “Theoretical framework”. Chapter 3 is “Methodology”, followed by chapter 4 “Description and analysis of the results”. Finally the results are discussed and concluded in the last part “Conclusions and implications for future studies”.