Recupero de costos en un hospital militar de Argentina

Abstract

The recovery of social security costs constitutes a source of financing for argentine public hospitals. Military hospitals can also recover the costs, although through a different process with limitations. It was proposed to evaluate the feasibility of improving it by: i) describe the recovery process, ii) quantify and characterize the not recovered costs and iii) identify the problems of the process and investigate alternatives for improvement. The cost recovery regulations were reviewed and the billing for hospitalizations of non–beneficiary patients of the military insurer during 2016–2018 was characterized. Difficulties were described and improvements suggested by interviews with key actors were proposed. A high rate of uncollectibility and delay in the payment chain and a low incidence of the resources recovered in hospital financing were verified. The need to establish formal agreements between the hospital and the provider and financing entities of the region was evident. These would allow the regional use of idle capacity in a highly complex hospital institution.