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O presente trabalho teve como objetivo identificar os valores dosmedicamentos de alto custo utilizados por portadores de Esquizofrenia Refratária atendidos em unidade ambulatorial. O estudo foi realizado através de uma análise de documentos em um Centro de Apoio Psicossocial, no período de junho de 2005 a maio de 2006, com 33usuários que faziam uso da medicação. A análise dos dados revelou que os medicamentos mais utilizados para os portadores de Esquizofrenia Refratária foram: clozapina de 100 mg e risperidona de 2 mg. Observou-se que o tratamento com o medicamento olanzapina 10 mg tem um custo mais alto e com o medicamento risperidona de 2 mg apresenta um custo mais baixo. Verificou-se que é necessário o monitoramento do consumo e dos custos dos medicamentos de alto custo, uma vez que fornece subsídios para melhor gerenciamento dos gastos e novos investimentos no serviço. Além disso, identificou-se também a necessidade de mais estudos na área para contribuir com o controle de custos.The present work aims to raise the costs of high-cost drugs used to treat patients of Refractory Schizophrenia in ambulatory unit. The study was carried out in the Psychosocial Support Center, which treated 33 patients with these medications, during the period of June, 2005 to May, 2006. Data analysis disclosed that the mostly used drugs to treat the carriers of Refractory Schizophrenia were: clozapina and risperidona. It was observed that the treatment with olanzapina is more expensive than that with risperidona. The study concluded that the analysis of the consumption and costs of drugs of high cost is necessary to subside better management of the expenses and new investments in the service. Moreover, the necessity of more studies in the area was also identified to contribute with the control of costs.

This study aimed at identifying the hospitalization costs of pregnant women with Diabetes Mellitus (DM) at a University Hospital. It is an observational, quantitative study with descriptive data analysis. The direct and indirect costs available in the institution were identified in order to determine the hospitalization costs for patients diagnosed with DM during pregnancy and childbirth. By means of descriptive statistics, it was observed that 63.46% of the patients had caesarean delivery; the mean total cost was R$ 362.93 (U$ 218.10)/hospitalization during pregnancy, R$ 2,642.65 (U$ 1,588.13)/hospitalization for caesarean delivery, and R$ 2.319.77 (U$ 1,394.09)/hospitalization for vaginal delivery. It was concluded that the analysis of hospitalization costs for patients with DM is of utmost importance, since they are high-complexity hospitalizations that require a large number of interventions, increasing thus the service costs.

Organizing health services is a challenge for managers. Moreover, patients’ absenteeism to appointments is a relevant issue. This study aims to evaluate the profile of absent users, the medical specialty, and reasons for absence from medical consultations in a reference clinic. This is a cross-sectional study conducted at a tertiary hospital in the state of São Paulo. Data was obtained from reports from the Hospital Center for Medical Informatics and electronic patient records (from January 1st to December 31st, 2018). Structured interviews were carried out (from April 2018 to February 2019) by phone with a random sample of 317 patients who were aged 18 years old or above and missed consultations in twelve medical specialties, after approval by the Research Ethics Committee. Analysis were performed using descriptive and analytical statistics, with a significance level set at 5%. In total, 69.09% of patients say they missed consultations. It is noteworthy that 18.06% of patients said they attended consultations, followed by those who claimed to be sick or hospitalized (16.98%, p-value=0.0006). Analyzing the context and reasons for absences generates knowledge for service management. We found inadequacies in scheduling and system records. Patients and health services must be co-responsible for optimizing the use of public health resources.

This study aimed at identifying the hospitalization costs of pregnant women with Diabetes Mellitus (DM) at a University Hospital. It is an observational, quantitative study with descriptive data analysis. The direct and indirect costs available in the institution were identified in order to determine the hospitalization costs for patients diagnosed with DM during pregnancy and childbirth. By means of descriptive statistics, it was observed that 63.46% of the patients had caesarean delivery; the mean total cost was R$ 362.93 (U$ 218.10)/hospitalization during pregnancy, R$ 2,642.65 (U$ 1,588.13)/hospitalization for caesarean delivery, and R$ 2.319.77 (U$ 1,394.09)/hospitalization for vaginal delivery. It was concluded that the analysis of hospitalization costs for patients with DM is of utmost importance, since they are high-complexity hospitalizations that require a large number of interventions, increasing thus the service costs.O trabalho teve como objetivo identificar os custos das internações de gestantes portadoras de Diabetes Mellitus (DM) de um Hospital Universitário. Trata-se de um estudo observacional, quantitativo com análise descritiva dos dados. Foram identificados os custos diretos e indiretos disponíveis na instituição para a determinação dos custos das internações de pacientes com diagnóstico de DM durante a gestação e no parto. Por meio de análise estatística descritiva, verificou-se que 63,46% das pacientes realizaram parto cesárea; o custo médio total foi de R$ 362,93/internação durante a gestação, R$2642,65/internação para o parto cesárea e R$2319,77/internação para o parto vaginal. Conclui-se que é extremamente importante a realização da análise dos custos das internações de pacientes com DM, pois são internações de alto risco, que requerem grande número de intervenções, aumentando os custos do serviço.