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Master's Dissertation
DOI
10.11606/D.5.2005.tde-16022006-153401
Document
Author
Full name
Alberto Hideki Kanamura
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2005
Supervisor
Committee
Viana, Ana Luiza D Avila (President)
Fortes, Paulo Antonio de Carvalho
Malik, Ana Maria
Title in Portuguese
"Gastos elevados na assistência médico-hospitalar de um plano de saúde"
Keywords in Portuguese
CUSTOS DE CUIDADOS DE SAÚDE
GASTO PÚBLICO NA SAÚDE PER CAPITA
PLANOS DE PRÉ-PAGAMENTO EM SAÚDE
Abstract in Portuguese
Administradores de saúde estão preocupados com a persistente elevação dos gastos com saúde. Um problema econômico, social e médico. Objetivando estudar as características das pessoas que produzem gastos elevados com saúde, tomou-se a população de um plano de saúde, identificou-se 1% dos casos que mais gastaram com assistência médico-hospitalar e analisou-se a distribuição por idade, sexo, natureza dos gastos, diagnósticos e o impacto no custo do plano. Os resultados revelaram que a idade é importante fator associado ao gasto elevado, que materiais e medicamentos constituíram a maior fração do gasto e os diagnósticos associados mais freqüentes foram doenças do aparelho circulatório e neoplasias malignas. A fração selecionada de 1% foi responsável por 36,2% da despesa e gastaram em média 56,3 vezes mais que os demais
Title in English
A health insurance's high medical expenditures
Keywords in English
HEALTH CARE COSTS
PER-CAPITA PUBLIC SPENDING ON HEALTH CARE
PREPAID HEALTH PLANS
Abstract in English
Healthcare managers are concerned with the persistent increasing of healthcare expenditure. An economics, social and medical problem. The objective of this study was to know the characteristics of the population that could predict high medical expenditure. It was selectec the 1% of customers (assisted by an healthcare plan) that generated the highest expenditures. The distribution by age, sex, kind of expenditure, diagnoses and the impact in insurance cost were analyzed. The results showed that the age is important associated factor, medical supplies and drugs were mainly responsible for expenditure. The main diagnose associated with high expenditure were circulatory diseases and cancer was the second. The 1% selected customers generated 36.2% of the total expenditure of their healthcare plan, and spent 56.3 times more than others customers, on average
 
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capasumario.pdf (17.77 Kbytes)
dissertacao.pdf (175.22 Kbytes)
Publishing Date
2006-02-24
 
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