Gestão orçamentária e financeira e o Programa de Reestruturação dos Hospitais Universitários: um estudo no Hospital da UFJF

Abstract

The case study presented in this paper focuses on the budgetary and financial management of the Juiz de Fora’s Federal University Hospital (JFFU-H), which delas with the Budgetary Deficit, the Federals University’s Hospitals Restructuration National Program (FUHRNP) and the Brazilian Company of Hospital Services (Empresa Brasileira de Serviços Hospitalares – EBSERH). Both the FUHRNP and EBSERH were created in order to solve the problems that were found by the Education Ministry (EM) in 2009, which ranges from underfunding and precarious labor to the lack of structural and technological conditions. These problems have prevented the federal university hospitals (FUHs) to acomplish the threefold mission of assistance, education and research. Reference in the health treatment in the region of it's city, Juiz de Fora MG, the JFFU-H has started to be maneged by EBSERH in the year of 2015, after the signing of a management contract that was established between the Juiz de Fora’s Federal University (JFFU) and EBSERH in 2014. During the transition period of it's management, the entirely year of 2015, the JFFU-H managers discussed with the employees and elaborated a Strategic Planning that presented the Budgetary Loss among the organizacional problems. Then came the fundamental question: "is the FUHRNP able to equate the budget loss of JFFU-H?". The present study aims to investigate the current budget loss of JFFU-H through strategic planning and if the budget loss was equalize dor solved, to analyze the investments made by the FUHRNP in the hospital between the years of 2011 and 2016, and to propose a plan with recommendations for JFFU-H to use the FUHRNP’s resources in order to contribute to the budget balance. From a field research, it was possible to point out the evidence of the Budgetary Loss (Chapter 1); through the documentary research, a theoretical reference was elaborated (Section 2.1) that mentions the main terms used in the budgetary and financial management in the public sector, allowing a better understanding of the qualitative research data collected in the federal government system (Tesouro Gerencial). Analysis of data focusing on Government Action and Nature of Expenditure (Section 2.3) shows that the FUHRNP didn't add a new budget to the JFFU-H, but the adhesion to EBSERH allowed a public tender to be carried out, which discharged the cost in provision of outsourced services by 2016. As the main source of funding for costing expenses, the FUHRNP could remedy the budget loss if the Ministério da Educação had acomplished what was determined by the decree that have created the program. It was concluded that for JFFUH to use FUHRNP resources efficiently, it was necessary to create some control strategies for the execution of expenditure and inventory, pre and post budget decentralization activities to solve the problems generated by Remains to Pay, contract analysis and Costs, monitoring of budget decentralization and spaces in the institution to discuss hospital financing. Such actions are contemplated in the Action Plan (Chapter 3) and will allow JFFU-H to also be a reference in budgetary and financial management.