Healthcare 4.0 e faturamento hospitalar: projeto de identificação e priorização de tecnologias da indústria 4.0

Abstract

The delays in closing medical bills are a common complaint among both private patients and those covered by hospital insurance plans. For private patients, the delay is often associated with payment negotiations and a lack of clarity regarding the amounts charged. For insured patients, the process is more bureaucratic, involving a series of verifications and authorizations carried out by the hospital administrative staff in conjunction with health insurance providers, including checks of medical records, prescriptions, and required signatures. This study aims to investigate which Industry 4.0 technologies, within the context of healthcare 4.0, can optimize this process and reduce delays. The methodology includes a systematic literature review conducted in the Scopus and Web of Science databases, complemented by field research with professionals in the hospital billing sector. The study contributes theoretically by mapping and prioritizing 14 Industry 4.0 technologies applicable to Brazilian hospital billing, and methodologically by combining qualitative content analysis with the Borda Count method for expert-driven prioritization. The social relevance of this study lies in the potential reduction of claim denials and administrative errors in Brazilian hospital billing, contributing to the financial sustainability of healthcare institutions and to the improvement of the quality of hospital services provided to patients. This study further contributes to the research line on Industry 4.0/5.0 and Artificial Intelligence within the scope of Advanced Project, Program, and Portfolio Management, emphasizing the role of technology as a strategic driver of transformation and competitiveness.