ANÁLISE DE COMPETITIVIDADE EX-ANTE NAS EMERGÊNCIAS HOSPITALARES: A NECESSIDADE DE AVALIAÇÕES ASSISTENCIAIS E ECONÔMICAS SIMULTÂNEAS

Abstract

Until 1970s years the accuracy of the numbers of the economical results dominated the decisions of management models, while the competitiveness just leaned on the contention of the costs. Traditional methods of costing like VBC (Volume Based Costing) were sufficient, and they assumed that the costs of the products and services vary basically according to the volume, as if there weren’t any difference among them, favoring an exact but dangerous result. Since then, pulled mainly by the globalization, there were significant changes in the scenery of the competitiveness, and the accuracy of the numbers is giving place to the need of the acurácia of the numbers - representativeness. The competitiveness becomes based on the quality. Of that need ABM appeared (Activity Based Management), where the management privileges the activities or factors that make the numbers happen, being the costing method of ABC (Activity Based Costing), an important tool of ABM. Considering that the competitiveness is the capacity of the development and the support of advantages of the competition, the accounting using ABC - ABM will be analyzing your decisive factors, and evaluating the capacity of the maintenance or of the conquest of new positions - competitiveness analysis ex-ante. In the health care, mainly in the emergencies rooms, where the services are extremely different, and there is great investment in human and technological resources, the search for efficiency (relationship resources versus resulted), and for effectiveness (if the expectation of the goal was reached), is incessant. Will be enabled to compete the emergencies rooms (or services in health care as a whole) that, besides the development of a costing system integrated to the medical protocols and routines, also work the continuous improvement of the premises "processes" and "people", and to develop models of cost-effectiveness for economical analysis.