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This study had the objective of estimating the costs to the public and private healthcare systems and to families of tuberculosis treatment and prevention. Data for estimating the costs to the healthcare system were collected from the Department of Health, healthcare facilities and a philanthropic institution. The public and private costs were analyzed using cost accounting methodology. Cost data relating to families were collected by means of questionnaires, and included data on transportation, food and other expenses, and also income losses associated with this disease. The cost of treating one multiresistant patient was 27 higher than this.
In applying the CECA to be proposed. How standards contribute to from theory to practice - implications for sustainable development. BSI White full cost environmental accounting. Paper, Acesso: 20 mar. Acesso em: 13 maio ISO reconceptualization. Critical Perspectives guidance on social responsibility, Geneva, on Accounting , v.
Universidad London. The management systems using a risk analysis concept of ecological accounting costs in based approach. Journal of Cleaner the context of sustainability. COPEC, p. Contabilidad de Costes , Universidad de Burgos, The literature review: six steps to success. Survey research in operations California: Corwin Press, Production Management, v.
Belo Experiences with integrated management Horizonte: Ed. UFMG, p. ISO guidance on v.
Keywords: Tuberculosis, epidemiology. Health care costs.
Cost of illness. Tuberculosis, costs to families. The same report has estimated that, if not controlled, tuberculosis will be responsible for the death of 35 million people over the next 20 years. Brazil ranks tenth in the world in numbers of cases, with around 83, cases notified every year, in all age groups but especially among those aged over twenty years old. In the State of Bahia, around 7, cases occur every year, which corresponded to an incidence of Of these, approximately 3, cases of tuberculosis occur in the city of Salvador every year, with an incidence of As well as the high cost to the healthcare system, tuberculosis puts a burden on family budgets, thus worsening poverty conditions.
This results not only from the direct costs related to the treatments, but especially from the income losses caused by the disease. The present study had the objective of estimating the economic costs of tuberculosis for the healthcare system and for the families of patients undergoing treatment for tuberculosis. It also aimed to contribute towards the development of similar studies in other contexts, through laying out in detail the methodology utilized.
METHODS To study the cost of tuberculosis for patients and their families, the sample size was defined by convenience, to include patients who had received a diagnosis of tuberculosis for the first time, 33 hospitalized patients and 39 patients with multiresistant tuberculosis.
The new cases were recruited from among the recently diagnosed cases of tuberculosis at ten healthcare centers in Salvador, State of Bahia.
The hospitalized patients were recruited from among the patients in the reference hospital for tuberculosis treatment in the city, and the multiresistant patients were recruited from the outpatient service of this same hospital. The information was collected using a standardized questionnaire that was administered by nurses, nursing auxiliaries or technicians and social workers who had been trained for this purpose.
For the new patients beginning outpatient treatment, the objective of the questionnaire was to obtain information on the costs that they had had prior to and subsequent to the start of tuberculosis treatment.
The new patients were recruited during the months of February and March For the hospitalized patients, the objective was to verify the costs during the six months preceding the date of hospitalization and the costs during their hospitalization. The hospitalized and multiresistant patients were recruited during the months of July and August For the multiresistant patients, the objective was to estimate the costs over a one-year period prior to the date of the interview.
For the new outpatients, the questionnaires were applied on three occasions: at the start of their treatment to register their costs prior to the diagnosis and three and six months later. This last application coincided with the end of the treatment. For the multiresistant and the hospitalized patients, the questionnaire was applied on a single occasion the information collected from the patients is shown in Table 1 published on ISC's website.
For this collection, six healthcare centers from among the twelve centers where tuberculosis control activities were being performed in the municipality of Salvador were selected. This selection was based on the availability of the information needed for calculating the costs. Thus, the centers that had all the information needed for the cost calculations were selected.
The files of the new outpatients and multiresistant patients were also reviewed in order to determine the average number of consultations and tests that these patients did. The files of the hospitalized patients were not reviewed. The costs of the epidemiological surveillance of tuberculosis were not estimated. For analysis, the procedures of cost accounting were utilized, in which the proportion of the resources that is utilized for each activity is considered in order to determine the unit cost of this activity.
The average cost to the family varied according to the type of treatment needed.
The average cost to a family for a hospitalized patient was calculated only for the number of days of hospitalization. Segundo Wind , p. Network Wizards — Jan. Segundo KPMG , p.
CFC, , p. Segundo Zanluca , p. Segundo o Conselho Federal de Contabilidade, em Fev. RAZA, , p. Segundo Laurentino , p. Duarte , p. Em pesquisa realizada por Duarte , p. Adaptado de Atkinson ; p. Segundo Marion , p.
Figura 1: Adaptado de Marion , p. Em outras palavras: Como Marion , p. De acordo com Martins , p. No entanto, o mesmo autor afirma em sua mesma obra p. Adaptado de Martins ; p. Teixeira , p. De acordo com Johnson e Kaplan , p. De acordo com Oliveira , p. Segundo Oliveira , p. Ainda segundo Oliveira , p. Componentes do ambiente Fonte: Figura 8: Porter , p.
Oliveira , p.
No contexto do ambiente interno da empresa, devem-se levar em conta os pontos fortes e fracos, ou seja, aquilo que a empresa faz bem e aquilo que precisa ser melhorado. Figura 9: Mintzberg, apud Ansoff , p. A matriz BCG Fonte: Adaptado de Boston Consulting Group http: Tabela 3: Adaptado de Oliveira , p. No entanto, segundo Oliveira , p. Logo, o executivo deve levar em conta os seguintes fatores: Tabela 4: Autor 2.
Segundo Mintzberg , p. Todos os escritores trataram dessa etapa superficialmente. Figura Adaptado de Mintzberg , p. FAHEY, , p.