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Publication
A contabilidade de gestão no setor público da saúde em Portugal: estudo de caso
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| 3.01 MB | Adobe PDF |
Advisor(s)
Abstract(s)
Os serviços públicos de saúde atravessaram momentos de grande pressão, pela resposta em
primeira linha à pandemia e pela limitação crescente dos recursos à sua disposição. Para realizar
uma gestão eficiente dos recursos, os hospitais devem dispor de ferramentas que os auxiliem
nas decisões, condição imprescindível à sustentabilidade do SNS. No contexto da normalização
contabilística, pretende-se aprofundar o conhecimento das práticas de Contabilidade de Gestão
(CG) nas Entidades Públicas Empresariais (EPE) da saúde, em geral, e estudando, em
particular, o Centro Hospitalar Universitário de São João (CHUSJ) e o Centro Hospitalar
Universitário do Porto (CHUP). O primeiro objetivo é verificar o cumprimento da Norma de
Contabilidade Pública 27 (NCP 27) em 2021, recorrendo a fontes secundárias de informação,
através da análise dos Relatórios e Contas (RC) retirados dos websites das entidades. Para
concretizar o segundo objetivo foi realizada uma abordagem qualitativa, através de um estudo
de caso, para descrever e comparar os sistemas de CG existentes nos dois centros hospitalares
e explorar o grau de utilização da CG como ferramenta de apoio à decisão. Recorreu-se a fontes
primárias de informação, realizando entrevistas semiestruturadas, com diferentes atores da área
da gestão. Para tratamento e análise dos dados utilizou-se o software Atlas.Ti. Os resultados
sugerem que a CG não é uma realidade na generalidade dos hospitais EPE. Nos dois casos em
estudo, os únicos centros hospitalares que trabalham a CG e divulgam nos seus RC, foram
verificadas diferenças substanciais nos sistemas de CG, tendo existido um claro investimento,
num caso, e uma clara resiliência dos profissionais, no outro. Comum é a perceção da carência
de recursos humanos na área, o que compromete a qualidade da informação produzida, as
decisões nela baseadas e a eficiência na prestação dos cuidados de saúde. A prática só será
alargada a todos os hospitais quando o Ministério da Saúde (MS) o determinar e criar as
condições necessárias, promovendo a autonomia e a responsabilização.
Public health services have been under a great deal of pressure, due to the first-line response to the pandemic and the increasing limitation of the resources at their disposal. To manage resources efficiently, hospitals must have tools to help them make decisions, which is essential for the sustainability of the National Health Service (NHS). In the context of accounting standardisation, this dissertation aims to gain a deeper understanding on Management Accounting (MA) practices in Public Business Entities in the health sector in general, and to study CHUSJ and CHUP, in particular. The first objective is to verify compliance with Public Accounting Standard 27 (NCP 27) in 2021, using secondary sources of information, by analysing the Annual Reports and Accounts taken from the entities' websites. To achieve the second objective, a qualitative approach was taken, through a case study, to describe and compare the existing MA systems in the two cases and explore the degree to which MA is used as a decision-support tool. Primary sources of information were used, and semi-structured interviews were carried with different players in the management field. Atlas.Ti software was used to process and analyse the data. The results suggest that MA is not a reality in most public hospitals. There were substantial differences in MAS, in the two cases under study, with a clear investment, in one case, and a clear professionals’ resilience, in the other. There is a common perception of a lack of human resources in the area, which compromises the quality of the information produced, the decisions based on it and the efficiency of healthcare provision. The practice will only be extended to all hospitals when the Ministry of Health (MoH) determines it and creates the necessary conditions, promoting autonomy and accountability.
Public health services have been under a great deal of pressure, due to the first-line response to the pandemic and the increasing limitation of the resources at their disposal. To manage resources efficiently, hospitals must have tools to help them make decisions, which is essential for the sustainability of the National Health Service (NHS). In the context of accounting standardisation, this dissertation aims to gain a deeper understanding on Management Accounting (MA) practices in Public Business Entities in the health sector in general, and to study CHUSJ and CHUP, in particular. The first objective is to verify compliance with Public Accounting Standard 27 (NCP 27) in 2021, using secondary sources of information, by analysing the Annual Reports and Accounts taken from the entities' websites. To achieve the second objective, a qualitative approach was taken, through a case study, to describe and compare the existing MA systems in the two cases and explore the degree to which MA is used as a decision-support tool. Primary sources of information were used, and semi-structured interviews were carried with different players in the management field. Atlas.Ti software was used to process and analyse the data. The results suggest that MA is not a reality in most public hospitals. There were substantial differences in MAS, in the two cases under study, with a clear investment, in one case, and a clear professionals’ resilience, in the other. There is a common perception of a lack of human resources in the area, which compromises the quality of the information produced, the decisions based on it and the efficiency of healthcare provision. The practice will only be extended to all hospitals when the Ministry of Health (MoH) determines it and creates the necessary conditions, promoting autonomy and accountability.
Description
Keywords
Contabilidade de Gestão (NCP 27) Sistema de Normalização Contabilística para as Administrações Públicas (SNC-AP) Entidade Pública Empresarial (EPE) Saúde Management Accounting (NCP 27) Accounting Standardisation System for Public Administrations (SNC-AP) Public Business Entity Healthcare