Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2017-05-24T13:39:46Z No. of bitstreams: 1 Marisa Rodrigues da Rosa_.pdf: 1337320 bytes, checksum: ff3b2d247569a59c27dc56e40a786e68 (MD5) / Made available in DSpace on 2017-05-24T13:39:46Z (GMT). No. of bitstreams: 1 Marisa Rodrigues da Rosa_.pdf: 1337320 bytes, checksum: ff3b2d247569a59c27dc56e40a786e68 (MD5) Previous issue date: 2017-01-13 / Nenhuma / Objetivo: Propor uma padronização da gestão do processo de auditoria interna para a melhoria da qualidade dos serviços de um hospital privado na cidade de Santa Maria, no interior do Rio Grande do Sul. Método: Pesquisa transversal, cujos dados foram coletados de maneira prospectiva, por meio da análise de 200 prontuários, após a alta dos pacientes internados em uma das unidades de atendimento clínico-cirúrgicas, no período de agosto a outubro de 2016, a fim de identificar as glosas ocorridas no período. Resultados: Verificou-se que a categoria com maior quantidade de glosas é a de técnico em enfermagem, sendo o turno da tarde o de maior ocorrência delas. Os erros de prescrição médica foram prevalentes, totalizando 56,3% do total; entre eles, os medicamentos suspensos representaram 80,6%. Os erros de enfermagem mais frequentes são os de prescrição de cuidados realizados e não checados, representando 62,5% do total. As glosas mais encontradas das contas auditadas foram em relação aos custos dos procedimentos remunerados. Para minimizar as glosas, foram sugeridos: encontros semanais entre enfermeiros auditores e a equipe assistencial, criação de um checklist para o carro de emergência e dispensação de medicações por dose unitária. Conclusão: Fica clara a necessidade de implantar um processo de auditoria, atrelando qualidade assistencial e cobranças hospitalares ao cotidiano dos enfermeiros. / Objective: Propose a standardization of the internal audit process's management, to the improvement of services quality of a private hospital in the city of Santa Maria, a country side city of Rio Grande do Sul. Method: Transversal research, prospectively collected, through the analysis of 200 medical records, after the discharge of patients hospitalized in one of the clinic-surgical units from August to October 2016, in order to identify the glosses Occurred in the period. Results: It was verified that the category with more hospital gloss quantity is the nursing technician, being the afternoon the shift with more occurrences of it. The medical prescription errors were the prevalent, totalizing 56.3% of total; between them, the suspended medicines represented 80.6%. The most frequent nursing errors are the ones of prescriptions of realized care and not verified, representing 62.5% of total. The hospital gloss more found in the audited accounts were in relation to the costs of remunerated procedures. To minimize the hospital gloss, it was suggested: weekly meeting between the nurses’ auditors with the assistential team, creation of a checklist to the emergency car and the dispensation of medications per unit dose. Conclusion: It's clear the necessity of the implantation of an audit process, unifying assistential quality and hospital charges to the day by day of nurses.

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2016-09-15T13:14:21Z No. of bitstreams: 1 André Reckziegel_.pdf: 2104679 bytes, checksum: f9dbfe75cac9db4e12b7c776ee3b2764 (MD5) / Made available in DSpace on 2016-09-15T13:14:21Z (GMT). No. of bitstreams: 1 André Reckziegel_.pdf: 2104679 bytes, checksum: f9dbfe75cac9db4e12b7c776ee3b2764 (MD5) Previous issue date: 2016-07-21 / Nenhuma / Este estudo tem como objetivo mensurar os efeitos percebidos sobre indicadores de custos, decorrente da aplicação Lean Healthcare em processos hospitalares. O trabalho baseou-se na pesquisa tipo estudo de caso de abordagem descritiva de dados, de natureza quali-quantitativa, em um Hospital Geral Privado de Porto Alegre. Concluiu-se que não é possível mensurar corretamente os efeitos percebidos sobre indicadores de custos, decorrente desta aplicação, através das demonstrações contábeis empregadas pelo hospital. Percebeu-se variação em indicadores econômicos gerencias da organização, mas esses não refletem completamente as evidências operacionais de melhoria evidenciadas pela aplicação Lean Healthcare e a percepção dos envolvidos neste projeto. Por fim foi relacionado os resultados evidenciados com a literatura descrita, possibilitando colocar algumas sugestões futuras ao hospital, no sentido de começar a discutir adequações em seus sistemas informatizados e, em especial, o sistema contábil e seus demonstrativos, no sentido de prepará-los para mensurar corretamente efeitos em custos, decorrente de novas aplicações Lean em seus processos hospitalares. / This study aims to measure the perceived effects on cost indicators, arising from Lean Healthcare application in hospital processes. The work was based on research case study type of descriptive data approach of qualitative and quantitative nature, in a private general hospital in Porto Alegre. It was concluded that it can not correctly measure the perceived effects on cost indicators deriving from this application through the financial statements used by the hospital. It was noticed change in managerial organization economic indicators, but these do not reflect completely the improvement of operational evidence evidenced by applying Lean Healthcare and the perception of those involved in this project. Finally the results shown with the described literature were related, allowing put some further suggestions to the hospital, to start discussing adjustments in its computer systems and, in particular, the accounting system and their statements, to prepare them for correctly measure effects on costs due to new applications Lean in their hospital processes.

The purpose of the study is to evaluate hospital costs in Kaunas Medical University Hospital (KMUH). KMUH is the largest hospital in Lithuania, having 1995 in-patient beds, 26 specialised in-patient departments, 5130 employees, and providing wide range of in-patient services. Methods. Methods, used in the study include assessment of inputs and outputs, evaluation of average cost per case, estimation of cost structure, estimation of case-mix dimensions in in-patient departments and clinical categories and assessment of impact of case-mix dimensions to cost per case, using multiple regressionanalysis. Cross-sectional study designwas used in the study, evaluating mainly cases and expenses of all 26 specialised in-patient departments of KMUH per year 2002. Five cost groups have been used and defined inmonetary terms in each in-patient department: labour costs; medication costs; laboratory, radiology and anaesthesiology costs; running costs of medical equipment supply andother costs (including in-patients’ mealcosts, transportation, laundry, communication, etc. costs). Case was defined as one treatment episode in particular in-patient department. Cases were analysed using following case-mix dimensions: sex, age, absenceor presence of surgical operation, patient separation status and in-patientservice group. Results. Average costs per case vary widely among in-patient departments, ranging from 126.01 Litas (36.52 Euro) to 3451.68 Litas (999.73 Euro) per case.During the study average cost per case were also estimated in clinical profiles – surgery – 1161.0 Litas (336.24 Euro), therapy – 1312.15 Litas (380.02 Euro),obstetrics and gynaecology –685.82 Litas (198.62 Euro), newborn and child care – 893.54 Litas (258.78 Euro) and intensive care – 1292.92 Litas (374.45 Euro). Using multiple regression analysis method, costper case ineach in-patient department and clinical category according case-mix dimensions were predicted. In all in-patient departments predicted values of average costs per case according case-mix dimensions, comparing with actual values, did not differ so much. Positive contributions to predictedvalue of cost per case, shows only one variable – IA in-patient service group. In any predicted case contributions of independent variables have notbeen observedas significant (p&gt;0.05). Conclusions. Inputs (measured in the number of beds) and outputs (measured in the number of in-patientcases and the number of bed-days) are different across in-patient departments, as well as outputs (measured inthe number of treatment episodes according to case-mix dimensions). The average costs per case vary widely across in-patient departments and clinical categories. The analysis of the structure of average costs per case demonstrated striking differences in in-patient departments. In all in-patient departments the predicted values of the average costs per case according to case-mix dimensions, do not differ so much comparing with theactual observed costs per case. Positive contributions to the predicted value of the cost per case, shows only onevariable – IA in-patient service group. The results of the study have proved the evidence that clinical casestreated within the same in-patient department of the hospital are not similar. The results of studyhave showedthe failure of use of “in-patient service groups” as proxy of International Disease Classification due to numberof reasons / <p>ISBN 91-7997-101-6</p>

::Dissertation (D.P.H.)--University of Michigan.

::Dissertation (D.P.H.)--University of Michigan.

Todos os países, independente do modelo de assistência à saúde adotado, têm compartilhado de um problema comum, os custos explosivos frente a recursos ou orçamentos limitados. Assim, custos crescentes e elevados dos serviços de saúde têm afetado todos os prestadores de serviços, sejam públicos ou privados. Na atual realidade financeira da saúde os hospitais terão que adotar um sistema para se ter um melhor controle dos processos de trabalho e informações precisas que possibilitem avaliar os resultados financeiros do hospital. As enfermeiras administradoras estão cada vez mais sendo envolvidas em decisões financeiras, no planejamento orçamentário de suas instituições, tendo que gerir recursos (humanos, materiais e financeiros) muitas vezes escassos. Diante destas considerações, constata-se a importância da enfermeira enquanto geradora de receita por ações prescritas ao paciente e como gestora das atividades realizadas na sua unidade, demandadas por outro profissional, principalmente em um hospital privado, onde as maiores fontes pagadoras são os convênios. Assim os objetivos desse estudo foram: calcular o faturamento gerado pelos procedimentos de enfermagem em uma unidade de terapia intensiva e calcular a porcentagem do faturamento gerado pela enfermagem em relação ao faturamento total da UTI. Tratou-se de uma pesquisa exploratória, descritiva, documental, com abordagem quantitativa. Foi realizado em uma UTI geral, de um hospital geral, privado, de grande porte, com 407 leitos, na cidade de São Paulo. A amostra foi de 159 pacientes. As fontes para obtenção dos dados foram as prescrições de enfermagem, as prescrições médicas, a fatura do paciente, o guia para apontamento em planilhas e procedimentos da qualidade. Foram elaborados dois instrumentos para coleta de dados. Concluiu-se que os procedimentos da prescrição de enfermagem, que mais contribuíram, foram: verificar débito cardíaco, instalar VAMP, colocar trackcare, trocar filtro umidificador, verificar pressão capilar pulmonar e fazer curativos e os procedimentos de enfermagem, da prescrição médica, que mais contribuíram foram: dieta enteral, dieta parenteral (NPP) e diálise. Em média, o faturamento recebido de cada paciente foi de R$8.918,30; o faturamento dos procedimentos de enfermagem, oriundos da prescrição de enfermagem foi de R$1.230,33 e os da prescrição médica foi de R$508,57. Em média o faturamento da prescrição de enfermagem foi de 11,3%, ou seja, o faturamento da prescrição de enfermagem foi maior que o da prescrição médica; sendo 5,4% com mão-de-obra e 5,9% foram com materiais e em média, 3,8% do faturamento obtido de cada paciente, foi da prescrição médica; desses, 1,4% foi com mão-de-obra e 2,4% foi com materiais. Obteve-se, então, que os procedimentos de enfermagem foram responsáveis por 15,1% do faturamento total da UTI. A abordagem do tema representou um grande desafio pela falta de literatura específica a respeito, além de ser uma realidade, praticamente, nova para a enfermeira que, hoje, é considerada gestora de sua unidade de negócio. / Every country, no matter the health assistance model adopted, has been sharing a common problem: high costs facing limited resources and budgets. Thus, growing and high costs of health services have been affecting all public or private service providers. In the current financial health reality, hospitals will have to adopt a system to get a better control of work processes and precise information to make possible to evaluate the Hospital’s financial results. Nurse managers are even more involved in financial decisions, and budget institution planning and have to manager human, material and financial resources which sometimes are rare. Facing those considerations, the importance of the nurses is proven as income generator by actions prescribed to patients and as managers of activities held at their units, demanded by another professional, mainly at a private hospital, where major payer sources are medical health care. Thus, this study objects were: calculating incoming generated by nursing procedures at a intensive care unit and calculating percentage of incoming generated by nursing facing the total IUC incoming. It was an exploratory, descriptive, documental and quantitative approach research. It was held at a general ICU at a general private big hospital with 407 beds in the city of São Paulo. 159 patients were enrolled for the sample. Data sources were nursing prescriptions, medical prescriptions, patient’s invoice, permit to note in spreadsheet and quality procedures. Two data collection instruments were elaborated. We concluded nursing prescription procedures that contributed most were: verifying heart debt, installing VAMP, placing trackcare, changing humidifier filters, verifying pulmonary capillary pressure and plastering and nursing medical prescription procedures that contributed most were: enteral diet, parenteral diet (NPP) and dialysis. As an average, incoming received from each patient was R$8.918,30; nursing procedure incoming, from nursing prescription was R$1.230,33 and those from medical prescription was R$508,57. Nursing prescription incoming was 11,3%, that means, nursing prescription incoming was higher than the medical prescription one; nursing prescription turnover was higher than medical prescription turnover; it was 5,4% with workforce and 5,9% with materials, and 3,8% of each patient turnover was from medical prescription; of these, 1,4% was with workforce and 2,4% with materials. We concluded that nursing procedures were responsible for 15,1% of total ICU incoming. This approach represented a great challenge due to the lack of specific literature, and it is an almost new reality for nurses considered managers of their business unit today.

Orientador: Neury José Botega / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T16:12:43Z (GMT). No. of bitstreams: 1 Sgobin_SaraMariaTeixeira_M.pdf: 1926254 bytes, checksum: 107ab5117d2523a5185ac3e39e1f3408 (MD5) Previous issue date: 2013 / Resumo: O suicídio, ao longo dos anos, vem se tornando um problema de saúde pública. Além do impacto emocional e social, a morte prematura por suicídio implica um grande impacto econômico. Apesar de se estimar que as tentativas de suicídio sejam de 10 a 20 vezes mais frequentes que o suicídio, seu impacto socioeconômico é pouco estudado. Na tomada de decisão para medidas de prevenção do comportamento suicida, o conhecimento do ônus financeiro, levando-se em conta o custo do suicídio e de tentativas de suicídio, pode ser um forte sensibilizador de gestores públicos para a implementação de estratégias de prevenção, e estimular futuros estudos de custo efetividade. No Brasil, segundo o que pudemos revisar, não há dados publicados a esse respeito, sendo este, o intuito do presente estudo. Objetivo: Descrever os custos direto (custo diretamente ligado ao tratamento da tentativa de suicídio) e indireto (perda de produtividade após a tentativa de suicídio) de casos de tentativas de suicídio com alta intencionalidade suicida e alta letalidade de método internados em um hospital geral universitário, e comparar esses custos aos de casos de síndrome coronariana aguda internados no mesmo hospital, no mesmo período. Método: Estudo observacional comparativo tipo análise de custo de doença desenvolvido com pacientes internados no Hospital de Clínicas da Universidade Estadual de Campinas. Resultados: Os valores médios de custo encontrados por episódios de tentativa de suicídio de alta intencionalidade suicida e alta letalidade de método foram: custo direto individual R$10635,62 ($6168,65USD), Custo indireto individual R$1186,35 ($688,08 USD) e, custo total de R$12.351,31 ($7163,75USD). No grupo de síndromes coronarianas agudas, o custo direto médio por episódio foi R$7989,56 ($4633,94 USD), e o custo indireto médio foi R$2228,15 ($1292,27 USD). O custo total por episódio foi R$10220,61 ($5929,95 USD). A análise comparativa entre os diferentes tipos de custo (custo direto, custo indireto e custo indireto familiar), indica uma diferença significativa entre os custos indiretos a familiares dos dois fenômenos, apontando para custos significativamente mais elevados no grupo de tentativas de suicídio (p=0,0022 e 0,0066 quando ajustado para a idade). Conclusão: as tentativas de suicídio graves, com alta intencionalidade suicida e alta letalidade de método utilizado na tentativa de suicídio podem apresentar um custo econômico total tão elevado quanto às síndromes coronarianas agudas, doença com maior fardo econômico mundial. Dentre os componentes do custo direto, o custo hospitalar é responsável pela maior parte dos custos, particularmente as diárias hospitalares. Um dos achados mais importantes deste estudo foi à diferença encontrada entre o custo indireto familiar dos dois eventos. Familiares da amostra de pacientes com tentativa de suicídio apresentaram um custo indireto significativamente maior que familiares do grupo de pacientes de síndrome coronariana aguda. Este fato reforça a ideia que o comportamento suicida não afeta apenas o indivíduo, mas sim o meio social à sua volta: emocionalmente e economicamente / Abstract: Besides the socio-emotional impact, the premature death caused by suicide implies a high economic impact. Although being more frequent, the social-economical impact of suicide attempts is little studied. The knowledge of this financial burden, through studies of direct and indirect costs may be a strong sensitizer of public gestors for the implementation of prevention strategies. Considering suicide prevention in Brazil, there are no published data about it. Objective: to describe the direct and indirect costs of suicide attempt cases with high suicide intention and high lethality of the method taking in account inpatients of general university hospital and to compare to the costs of acute coronary syndrome cases considering inpatients of the same hospital. Method: a comparative observations study analyzing the cost of the illness. Results: the average values of the costs met per episodes of suicide attempt were: direct individual cost $6168,65 USD, indirect individual cost $688,08 USD and total cost of $7163,75 USD. In the group of acute coronary syndromes, the direct cost per episode was $4633,94 USD, the indirect average cost was $1292,27 USD, and the total cost per episode was $5929,95 USD. The comparative analysis among the different types of cost (direct cost, indirect cost and family indirect cost) shows a meaningful difference between the indirect costs and the family cost of the two phenomena with meaningfully more elevated costs in the group of suicide attempts (p=0,0022 and 0,0066 when age adjusted). Conclusion: the severe suicide attempts may present a total cost as elevated as the acute coronary syndromes, an illness with the biggest economic burden in the world. Among the components of the direct cost, the hospital cost is responsible for most of the costs. An important finding of this study was the meaningful difference between the indirect family costs of the two events. Relatives of the patients with suicide attempt showed an indirect cost significantly higher than relatives of patients with acute coronary syndrome. This fact reinforces the idea that the suicide behavior does not affect only the individual but the social environment around him/her, both emotionally and economically / Mestrado / Saude Mental / Mestra em Ciências Médicas

Competition among hospitals and managed care have forced hospital industry to be more efficient. With higher degrees of hospital competition and managed care penetration, hospitals have argued that the rate of increase in hospital cost is greater than the rate of increase in hospital revenue. By developing a payer-specific case mix index (CMI) for third-party patients, this paper examined the effect of hospital case mix on hospital cost and revenue for third-party patients in California using the hospital financial and utilization data covering 1986-1998. This study found that the coefficients for CMIs in the third-party hospital revenue model were greater than those in the hospital cost model until 1995. Since 1995, however, the coefficients for CMIs in the third-party hospital revenue model have been less than those in hospital cost models. Over time, the differences in coefficients for CMIs in hospital revenue and cost models for third-party patients have become smaller and smaller although those differences are statistically insignificant.

This is a quantitative study of archival data that examines Merger and Acquisition (M&A) activity using currently established healthcare quality and financial performance metrics. The research seeks to explicate the relationship between M&A activity and M&A experience in the healthcare industry as it relates to initiatives aimed at improving the quality and decreasing the cost of healthcare. The Affordable Care Act (ACA) legislation appears to be contributing to a trend toward M&A consolidation; by illuminating how this trend potentially impacts healthcare quality and cost reduction initiatives, this study’s contribution is both useful and practical. The units of analysis are Medicare reporting hospitals, hospital systems, and related healthcare providers that have or have not experienced an M&A or multiple M&As. The study shows a statistically significant improvement in quality each year from 2006–2014, which is reflected in higher scores for the four quality metrics measured. M&A activity, as measured by acquisition status and acquirer experience, did not appear to influence these quality metrics, with the exception of the heart failure measure, which showed a statistically significant positive influence of acquirer experience across all specifications. M&A activity’s possible effects on hospital financial performance was assessed through operating-cost-to-charge and capital-cost-to-charge ratios (CCRs). The operating CCR appears to be positively influenced by both acquisition status and acquirer experience, while the capital CCR was positively influenced only by acquirer experience. A positive influence is reflected in a decreasing ratio. Results on quality improvement over time, both before and after the ACA, suggest that the ACA itself may not be the driver for quality improvement. Similarly, decreases in OCCR occurred consistently and statistically significantly over time, both pre- and post-ACA, while CCCR showed statistically significant decreases in 2006–2008, 2013, and 2014. These results appear to support the notion that the trend was ongoing before the ACA was enacted and gave these measures high-profile exposure. This is a quantitative study of archival data that examines Merger and Acquisition (M&A) activity using currently established healthcare quality and financial performance metrics. The research seeks to explicate the relationship between M&A activity and M&A experience in the healthcare industry as it relates to initiatives aimed at improving the quality and decreasing the cost of healthcare. The Affordable Care Act (ACA) legislation appears to be contributing to a trend toward M&A consolidation; by illuminating how this trend potentially impacts healthcare quality and cost reduction initiatives, this study’s contribution is both useful and practical. The units of analysis are Medicare reporting hospitals, hospital systems, and related healthcare providers that have or have not experienced an M&A or multiple M&As. The study shows a statistically significant improvement in quality each year from 2006–2014, which is reflected in higher scores for the four quality metrics measured. M&A activity, as measured by acquisition status and acquirer experience, did not appear to influence these quality metrics, with the exception of the heart failure measure, which showed a statistically significant positive influence of acquirer experience across all specifications. M&A activity’s possible effects on hospital financial performance was assessed through operating-cost-to-charge and capital-cost-to-charge ratios (CCRs). The operating CCR appears to be positively influenced by both acquisition status and acquirer experience, while the capital CCR was positively influenced only by acquirer experience. A positive influence is reflected in a decreasing ratio. Results on quality improvement over time, both before and after the ACA, suggest that the ACA itself may not be the driver for quality improvement. Similarly, decreases in OCCR occurred consistently and statistically significantly over time, both pre- and post-ACA, while CCCR showed statistically significant decreases in 2006–2008, 2013, and 2014. These results appear to support the notion that the trend was ongoing before the ACA was enacted and gave these measures high-profile exposure.

Introdução: A unidade de terapia intensiva (UTI) é conhecida por ser um setor de alta complexidade dos pacientes e por seu alto custo ao sistema hospitalar. A gravidade da doença, o tempo de internação na UTI e a necessidade de ventilação mecânica invasiva (VMI) são fatores conhecidos como influenciadores no custo destas unidades, sendo que aproximadamente 30% dos pacientes internados em UTI necessitam de VMI. Os objetivos deste estudo foram avaliar os custos de internação em UTI comparando unidades com assistência de fisioterapia 24 horas e unidades com assistência de fisioterapia 12 horas e analisar o impacto da fisioterapia nos referidos custos. Método: Este é um estudo observacional, prospectivo, realizado em um hospital geral, público e de grande porte, localizado na cidade de São Paulo. Foram incluídos pacientes clínicos e cirúrgicos com 18 anos de idade ou mais, que estiveram em VMI por um período >= 24 horas e que receberam alta da UTI para a enfermaria. A coleta de dados incluiu diagnóstico de internação hospitalar, diagnóstico de admissão na UTI, gravidade do paciente no momento da admissão na UTI através do Acute Physiology and Chronic Health Disease Classification (APACHE II), tempo de VMI e tempo de internação na UTI; para a análise de custos utilizamos a ferramenta Omega French Score. Um modelo de regressão linear múltipla foi construído para verificar a associação entre o custo de internação em UTI com o turno diário de assistência fisioterapêutica. Resultados: Foram incluídos na amostra 815 pacientes, distribuídos em dois grupos conforme o turno de fisioterapia existente na UTI: 332 pacientes em UTI\'s com 24 horas de assistência fisioterapêutica (PT-24) e 483 pacientes em UTI\'s com 12 horas de assistência fisioterapêutica (PT-12). Os grupos não apresentaram diferença quanto ao APACHE II (p=0,65); comparado ao grupo PT-12 o grupo PT-24 era mais velho (p < 0,001), apresentou menor tempo de VMI (p < 0,001) e de internação na UTI (p=0,013). Quanto a análise de custos o grupo PT-24 apresentou custos menores indicados pela menor pontuação no Omega 3 (p=0,005) e Omega Total (p=0,010), menor custo direto, custo com equipe médica e enfermagem (p=0,010). A análise de regressão linear múltipla indicou associação do custo da internação em UTI com as variáveis APACHE II (p < 0,001), tempo de internação da UTI (p < 0,001) e assistência fisioterapêutica em turnos de 24 horas (p=0,05). Conclusão: O grupo com assistência de fisioterapia em turnos de 24 horas apresentou custos menores sendo que a severidade da doença, o tempo de internação na UTI e a assistência de fisioterapia foram variáveis preditoras para redução de custo de internação na UTI / Background: Intensive care unit (ICU) is considered a complex and expensive hospital department. The severity of illness, the length of ICU stay and the need for invasive mechanical ventilation (IMV) are known as influencing factors of costs to these units and approximately 30% of patients admitted at ICU will need IMV. Our aim is to address the costs related to ICU stay by comparing units with the provision of a daily 24-hour physiotherapy shift to a regular 12-hour PT shift and to analyze the impact of physical therapy in ICU costs. Method: This is a prospective, observational study, carried out in a general, public and large hospital, located in the city of São Paulo. Were included in the sample clinical and surgical patients, aged >=18 years old, invasive mechanically ventilated (IMV) >= 24 hours and discharged to ward were included. Data collection included reason of hospital admission and reason of ICU admission; Acute Physiology and Chronic Health Disease Classification System II (APACHE II); IMV duration; ICU-LOS; for cost analysis we use the Omega French Score. A multiple linear regression model was constructed to verify the association between costs of ICU stay and daily shift of physiotherapy. Results: 815 patients were included, distributed into two groups: 332 patients at ICUs with 24-hour physiotherapy shift (PT-24) and 483 patients in ICUs with 12-hour physiotherapy shift (PT-12). There was no statistical difference between the groups regarding the APACHE II (p=0,65); the PT-24 group was older (p < 0,001), and featured better clinical outcome when compared to the PT-12 group with shorter IMV (p < 0,001) and duration of stay in the ICU (p=0,013). About cost analysis the PT-24 group showed lower scores on Omega 3 (p=0,005) and Omega (p=0,010), lower direct cost, cost of medical and nursing staff (p=0,010). Multiple linear regression reveal that costs of ICU hospitalization to be associated to APACHE II (p < 0,001), length of ICU stay (p < 0,001) and 24-hour physiotherapy assistance (p=0,05). Conclusion: Patients in the group with the assistance of physiotherapy in 24-hour shifts presented decreased total and staff costs, physiotherapy assistance were considered predictor for cost reduction.