ArticleRevista da Escola de Enfermagem da U S P2025
Nurse performance in hospital financial auditing: a single case study.
Article in Revista da Escola de Enfermagem da U S P, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo 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.
methodA 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.
resultsUnderbilling 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.
conclusionRetrospective 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.
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