Brazil: BRL22.5 billion of health expenses wasted in unnecessary hospital bills and examination
A study conducted by the Institute for the Study of Supplementary Health (IESS) estimates that approximately BRL22.5 billion of healthcare expenses in the country are unnecessary and can be avoided. Patients are burdened with hospital bills and laboratory tests which were not required for the medical condition.
IESS found that between 12 to 18% of hospital bills have undue items and between 25 to 40% of laboratory tests were not necessary. The data also highlighted that between 2002 and 2015 there was misappropriation of BRL5 billion in the public health system. While in the private healthcare, irregularities included excessive and unnecessary treatment or poor quality care, inadequate marketing of medicines and medical devices and tax evasion.
The report concluded that absence of transparent mechanisms in the healthcare system lead to such practices. The Brazilian healthcare system lacks transparency in pricing of inputs, health services and in the payment process for services. This makes it impossible to compare and control costs in the different steps that involve patient care. This is happening mainly because the model used for health care payments (fee-for-service) has loopholes.
The report suggested that to combat such practices in the industry, the payment systems need to be modernized. Hospitals should be rewarded for efficiency and best clinical outcome to the patient. They should be punished for waste and unnecessary exams, readmissions or worsening of clinical conditions caused by faulty care.