Evolution of Studies on Orthopaedic Surgery Regarding Cost Management Tools: A Systematic Literature Review

Author(s): Isabel Cristina Panziera Marques, Alba Katarine Marques de Carvalho

Objective: The subject of hospital management is relevant given the importance of these institutions in the social and economic sphere, as well as for their managers, considering that in the hospital context, which involves high costs, scarce resources, pressure for quality and good service, information on costs and performance is useful for efficient management. This systematic literature review (SLR) aims to extend knowledge of the evidence linking costing mechanisms to the performance results of health institutions, analysing articles written in the last 10 years dealing with surgery in the specialization of orthopaedics, filling an important gap in the literature.

Methods: Rigorous criteria for selection of articles is followed by use of the PRISMA meta-analysis, which gives an important overview of the types of studies made, as well as classification according to the cost management tools, leading to mapping costing methods and performance analysis.

Results: Studies were classified by measurement methods, costs of decision-making and control and elements of strategic cost management, showing that the greatest number of studies originate in the USA (69, 23%) and use the variable of statistical analysis (53, 85%) in the majority of strategic management methods. As for types of surgical procedures, arthroplasty leads the ranking, accounting for 34, 62% of studies.

Conclusions: Predominance of the use of standard costing as the method of measurement, use of control methods for decision-making and a tendency towards the practice of statistical analysis as a variable of the elements of strategic cost management, with studies of replacement surgery (hip, knee and shoulder) being most prominent. This study provides managers and public policy-makers with challenges and indicators of efficiency and effectiveness for better performance in orthopaedic surgical processes.

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