护士在医院财务审计中的表现：一项单案例研究
Nurse performance in hospital financial auditing: a single case study.
作者信息
Meneguin Silvia Helena, Nogueira Vânia Dos Santos Nunes, Bocchi Silvia Cristina Mangini
机构信息
Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil.
Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Departamento de Clínica Médica, Botucatu, SP, Brazil.
出版信息
Rev Esc Enferm USP. 2025 Jul 7;59:e20240391. doi: 10.1590/1980-220X-REEUSP-2024-0391en. eCollection 2025.
OBJECTIVE
To analyze the performance of nurses in retrospective financial audits, compared with that of "non-nurses", for remuneration of a hospital by supplemental health insurance providers.
METHOD
A single, quantitative, retrospective, documentary and analytical case study, using as the unit of analysis a set of 238 accounting bills invoiced by "non-nurses" and audited by nurses for outpatient procedures in the hemodynamics service of a public hospital in the state of São Paulo, from 2019 to 2021.
RESULTS
Underbilling was detected in 100% of the billing groups in the "billed < audited" category, regardless of the procedures performed, with a cumulative total of R$ 1,024,692.00, which, updated to September 2024, would correspond to R$ 1,344,125.00. In cases of undue charges, "billed > audited", there was a cumulative total of R$ 647,828.00.
CONCLUSION
Retrospective financial audits performed by nurses increase hospital revenue. Finally, this study contributes by demonstrating the need to train these professionals in economic and financial skills in health care, highlighting the importance of the emerging role of financial auditor nurses in the health care market.
目的
分析护士在回顾性财务审计中的表现，并与“非护士人员”进行比较，以确定补充医疗保险机构对一家医院的薪酬支付情况。
方法
采用单一、定量、回顾性、文献性和分析性案例研究，以圣保罗州一家公立医院血液动力学服务门诊程序中由“非护士人员”开具并经护士审计的238张会计账单为分析单位，研究时间为2019年至2021年。
结果
在“计费<审计”类别的所有计费组中均检测到少计费情况，无论所执行的程序如何，累计少计费金额为1,024,692.00雷亚尔，更新至2024年9月相当于1,344,125.00雷亚尔。在多计费情况（“计费>审计”）中，累计多计费金额为647,828.00雷亚尔。
结论
护士进行的回顾性财务审计增加了医院收入。最后，本研究通过证明有必要对这些专业人员进行医疗保健经济和财务技能培训，突出了财务审计护士在医疗保健市场中新兴角色的重要性，从而做出了贡献。
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