TITLE:
Integrative Review about Life-Cycle Cost Approaches in Healthcare Units: Evolution, Limits and Reflections for Public Health in Brazil
AUTHORS:
Ewerton Mendes Rosa, Leonardo Carnut
KEYWORDS:
Facility Design and Construction, Brazil, Health Resources, Rationalization, Publications, Health Care Costs, Conservation of Natural Resources, Unified Health System
JOURNAL NAME:
Theoretical Economics Letters,
Vol.10 No.5,
October
27,
2020
ABSTRACT: The objective of this study is to review the
Healthcare Units (HU) life-cycle cost approaches with an emphasis on the
project process, life-cycle cost, actors and measures to save resources. It was
a systematic integrative review whose search syntax expressed the poles
(phenomenon, population and context) of the question. The Virtual Health
Library (VHL) portal was used, which gathers 29 databases, with the time limit from
1977 to 2017 and in Portuguese, English and Spanish. All types of manuscripts
and methodologies were included. As gray literature, publications from the
Ministry of Health of Brazil about the object were collected and the narrative
method was used to synthesize the data. A total of 18 texts were included, all
foreign, covering different approaches. Case studies predominate, especially in
hospitals, with a description of more efficient systems and intervention
strategies. The concept of “life-cycle cost” of the building, although explicit
in a few texts (22%), guides decisions and interventions aimed at recovering
investment in the operation, despite the fact that many are focused on environmental
criteria. It was noticed that the economic context is the major driver of
measures aimed at operational rationalization in buildings. Only three
Brazilian publications are consistent with the evolution of discussions abroad.
It was found that the HU life-cycle approach is still mostly restricted to
recovering the initial investment in the operation phase. The discussion in the
Brazilian Unified Health System (SUS) is incipient and it is necessary to face
problems related to the lack of tools and information to the design and
management processes of the structure of this equipment.