Banca de DEFESA: FILIPE CARRILHO DE AGUIAR

ANALYSIS OF THE IMPACT ON COSTS IN THE INTENSIVE CARE UNIT OF A UNIVERSITY HOSPITAL DUE TO THE COVID-19 PANDEMIC

Health economics; Costs; Cost analysis; Covid-19.

The COVID-19 pandemic has had an overload on healthcare costs, especially in intensive care units. This cross-sectional study compared treatment costs pre-pandemic (2019) and during the pandemic (2020), focusing on patients with and without COVID-19 admitted to the intensive care unit. 280 were selected patients for non-probabilistic sampling. Costs were calculated using two modalities: absorption costing and Time driven Activity based costing (TDABC). In 2019, only absorption costing was used. In 2020, both methods were used from April to August, during the first wave of the pandemic. The data was obtained clinical and administrative records, medical records, cost and remuneration forms professional. The study aims to understand the financial impact of the pandemic on healthcare units intensive therapy. Data were analyzed using descriptive statistics, with measurements of central tendency and variability. Variables with P-value < 0.05 were considered significant. Bartlett and Levene tests were used to calculate homoscedasticity and cost variances between the NON-COVID-19 and COVID-19 groups. The student t-test was used for parametric variables and the paired Wilcoxon test for non-parametric variables. parametric. A linear regression of the COVID-19 group with time of hospitalization ≤ 15 days, including the Lilliefors test, linearity analysis, Spearman correlation (R2 ) and the construction of the linear regression line.

This study examined absorption modeling and average costs in 2019 and 2020. The impact of cost was determined by the ratio of absorption modeling between the years 2020 and 2019. In 2019, costs ranged from R$10,485 to R$116,929.07 depending on the duration of the period of hospitalization. In 2020, costs ranged from R$17,789.24 to R$77,666.98. There was a significant variation in average costs between the two years, with increases and decreases depending on the time interval. Absorption modeling had a impact on costs, with significant percentage variations in both years. The reason between absorption and TDABC showed a percentage overestimation in modeling by absorption in 2020. Revenues from January to December 2019 were R$1,302,090.97 and from April to August 2020 they were R$1,396,668.82. The research concluded that the pandemic of COVID-19 resulted in an increase in costs associated with admissions to the Unit of Intensive Care at the Hospital das Clínicas of the Federal University of Pernambuco. This increase was particularly notable in the first 15 days of hospitalization. The study also revealed that the financing provided by the Unified Health System was not enough to cover these costs, leading to a financial imbalance in the hospital. Additionally, it was observed that the absorption costing method was not efficient, resulting in an overestimation of the hospital deficit.