The economic efficiency of the Army Health System from the perspective of costs

Abstract

The research aims to bring technical subsidies on the policy of the Brazilian Army Health System, which prioritizes the care of its personnel in the military hospitals. The aim is to measure whether the policy of avoiding outsourcing contributes to the reduction of medical and hospital costs since, in order to provide such assistance, a complex health structure is maintained throughout the country, which in turn demands financial resources in maintenance of installations, equipment and human resources burdening the Army's budget and, in the long term, generates social security expenses, calling into question the view that the existence of own hospitals is more advantageous in terms of reducing expenses. The cost systems used by the Army are not aimed at providing accurate measurements of medical and hospital costs, which, added to the scarcity of research on health costs in the Army, raises doubts about the efficiency of the policy of maintaining its own health network. Surgical costs at HGES were analyzed using the Activity-Based Costing (ABC) method and compared to expenses incurred with surgeries performed in the private network. Data on HGES costs and expenses in the private network were compared by logistic regression, using the STATA® statistical analysis program, obtaining evidence that there is a strong relationship between higher costs when surgeries occur in accredited hospitals.