SIGIC. Hospitals postpone surgeries out of hours
It’s a question for a million dollars and even Ralph Fiennes in the magnificent Quiz Show movie, even with the help of production, would have difficulty getting it right: ‘How was a dermatologist at Santa Maria Hospital to win 400,000 euros on ten Saturdays?’ « I have no idea »; « Only the hospital board can tell how it was possible »; « Looking at the legislation it is difficult to see how this money has come, » are some answers that sunrise has gathered with doctors. The story advanced by TVI/CNN is still doing damage and last weekend there were several hospitals – for the Ministry of Health, it is more correct to say ULS – who have not performed any surgery in the Integrated Surgery Integrated Management System (Sigic), although official source of the ministry has responded to our newspaper that “the executive direction of the NHS is aware of the SNS surgeries on the weekend (Saturday, May 31, and May 31st Sunday, June 1), in the context of additional production (Sigic) ». The sunrise, on the other hand, spoke with cancer patients outside Lisbon, who saw their surgeries postponed. « We were told that because of the confusion of the 400,000 euros doctor is all being combed, but my surgery is expected to happen soon, » said one man in his 50s.
It is a good portrait of the disorientation that came up with the news of payments to medical teams, outside of normal hours.
To understand what is at stake, and not entering a very technical language, it should be said that each hospital has a waiting list. The respective board of directors decides which surgeries can be performed outside of ‘normal’ time, and then the patient needs to be codified, and here comes the GDH (homogeneous diagnostic group). And it is from this coding that the team involved in the operation receives. But here, as in other matters related to Sigic, there are several readings: there are those who say that it cannot be the surgeon to codify the patient and there are those who say yes, but then there must be a team that ‘oversees’ all codification – in a basic language the coding means the problem that the patient has, and the respective payment to which the team will be entitled to.
But here is also another point that is much talked about in the hospitals’ corridors: there are doctors who in normal times do not enter a operative block, or enter little, but when it touches the bell for overtime are soon ready to move forward.
Let’s look at what a doctor who headed several teams says, despite being against Sigic. «Sigic is done after normal working hours, it can be both weekend and weekdays after 4 pm. Second rule, it is made with the GDH (homogeneous diagnostic group) and has a certain fixed value contractual with the Board of Directors. Third, the office that controls the planning and audit of hospital centers has the strict obligation to control people who give payment order. 500,000 surgeries can be performed, but there are surgeries that this cabinet cuts and does not pay, because it is not framed in the legislation. The value may be about 750 for the team chief. It depends on the homogeneous diagnostic group. There are 300 euros GDH rates as there are others of 3,000 euros. This value is not for a person, it is for a team. That is, the value of GDH, in additional surgery, is to distribute, depending on the negotiation and agreement between doctors, nurses, diagnostic and therapeutic technician in the operating room room, invasive techniques, and, according to the board of directors, these surgeries are coded before this GDH ».
Looking at the legislation, it is easily realized that doctors involved in dubious accounts may have to return what they have improperly charged. « Only the inquiry can investigate the truth, but it is very strange anyone to be able to earn 50 thousand euros in a single Saturday, » said another doctor.
