Policies of modernizing health care infrastructure and management: an analysis of philanthropic hospitals financing by Brazilian Development Bank (BNDES)

Presenter: Rodrigo Mendes Leal, Brazilian Development Bank (BNDES)

Abstract

Background:
The National Bank for Social and Economic Development (BNDES) is a Brazilian state-owned institution and main provider of funds for long term financing of investments in the domestic economy. BNDES’s main mission consists of supporting the expansion, updating and continuous renewal of Brazil’s economic structure, increasing the economy competitiveness, giving priority to both the reduction in social and regional unbalances, and the employment maintenance and generation. In the scope of improve social development, BNDES supports projects of health care providers, public or private.
To improve the efficiency and the quality of health system, it’s important that hospitals realize significant investments in modernization of infrastructure and management. In Brazil, the philanthropic hospitals provide 40% of the public attendance, in terms of inpatient care. A great number of these non-profit institutions need modernization of administration and was suffering serious economic difficulties and limitations for making investments. Considering this, BNDES financed the strengthening of the philanthropies hospitals, by means of projects of financial recovery and modernization of health care infrastructure and management.

Objective:
The objective of this study is to analyze the results of the financing of the philanthropic hospitals supported by BNDES, from 1999 to 2008.

Methods:
It was utilized a sample of large philanthropic hospitals that was financed by BNDES. We analyzed information from technical visits (and interviews) from 4 hospitals, realized in 2008. Besides, we examined the evolution of indicators of finance and of productivity, obtained by means of a questionnaire that was answered by 6 institutions.

Results:
The interviews indicate that the BNDES financial support enables an effective reduction in the cost of capital and propitiates the improvement of the management, which are indispensable by the financial sustainability of these institutions. The quantitative analysis shows an important improve in financial indicators, besides a predominance of increase in some productivity indicators.

Conclusion:
This evaluation of a sample of hospitals funded indicates that the BNDES support was important to the financial recovery and modernization of health care infrastructure and management of these institutions. This is a valuable initiative of BNDES to improve the efficiency and effectiveness of the health system, in addition to the others strategic public policies.