Análise assistencial e financeira de uma operadora de autogestão do Ceará utilizando a ferramenta microsoft power bi

Abstract

This Final Course Project aims to analyze the healthcare and financial performance of a Self-Managed Health Insurance Provider through the use of Microsoft Power BI tool. The analysis was conducted taking into consideration the key characteristics of selfmanaged providers, as well as the legal ramework that defines and regulates their operations. Basic integration of Excel with ower BI was utilized, focusing on the defined calculations of the respective indicators. The application of results was performed using Data Analysis Expressions (DAX) to build the main healthcare and financial indicators, including morbidity, consultations per beneficiary, average cost per consultation, average cost per examination, quantity of examinations per beneficiary, examinations per consultation, average length of hospital stay (TMPH), cost per hospitalization (CPI), loss ratio, cost per user, and average ticket value (TKM). As main results, it was possible to conclude that the operator in question has the main characteristics of self-managed operators, such as a stable portfolio and a close to 100% loss ratio. At the same time, it was possible to conclude that the operator is operating in a financially healthy manner.