Positive Assessment of FONEMED in Brazil

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The FioPrev’s Fio-Saúde[1] managed care system of Brazil is already experiencing early positive results from using the FONEMED System, even though it is still in pilot operation. The FioPrev Executive Directory reported initial achievements and a projection of the expected impact in service utilization by the taking into consideration usage data and previous experience of FONEMED with another managed care program, in the city of São Paulo, during 2001.

The innovative project started operations in the beginning of December 2002 after FioPrev health plan identified FONEMED, a pioneer in the area of healthcare call centers, as an appropriate solution for its beneficiaries. The objective of the contract with FONEMED is the provision of healthcare orientation, assistance, and counseling by telephone to the employees of FioCruz, a large public foundation linked to the Ministry of Health of Brazil. The program follows a model successfully implemented in Europe, Canada, and the United States. By calling of a free telephone number (0800), beneficiaries of FioPrev have access to a team of nurses supported by physicians that utilize computer-based care protocols to provide appropriate acute case orientation to callers and also other basic health information. Cases that involve immediate or elective medical attention are dealt with by referral to emergency or ambulatory clinics as required.

The health plan operator realizes significant savings when a health problem can be solved by telephone contact alone. The economic impact of the rational use of resources and monetary savings are considered a crucial issue at a time when there are many uncertainties regarding the financial sustainability of the Fio-Saúde managed care program.

Maria da Penha Xavier, an employee of the BioManguinhos Technical Development Department, was one of the first users of FONEMED call center services. When her six-year old son João Pedro suffered a neck injury during play, she called the 0800 number to find out what should she do. “Really, a professional orientation is very important in such situations – after the nurse told me what to do before taking my son to see a physician I felt much less anxious”, she said.

When signs and symptoms detailed by the caller are suggestive that the situation cannot be solved by simple procedures, the patient is always oriented where to go to seek medial care. The professionals working for FONEMED are not allowed to recommend over the telephone any diagnostic tests or provide medications that require a prescription. If required, the professionals working in the system can dispatch emergency vehicles including a team of professionals and equipment in areas covered by Mobile Intensive Care Ambulances.

FONEMED brings together the convenience of medical orientation and counseling to the beneficiaries of the Fio-Saúde health plan and is also advantageous to the plan operator, as a consequence of the reduction of care costs.

There follows a projection of the positive impact of the initiative:

Forecast of the positive impact of FONEMED on utilization

Number of Fio-Saúde beneficiaries:  14,800

Users expected to use the system: 30% of beneficiaries  (4,440)

Percentage of callers that are expected to have their health problems solved by the FONEMED Call Center: 60% of callers (2,664 beneficiaries)

Hospital admissions avoided: 3% of users (80 beneficiaries)

Forecast of the financial impact of FONEMED

Outpatient savings: 2,664 office visits @ R$28.00 – savings of R$74,592.00/year

Diagnostic tests: each visit averages 3.2 tests with unit cost of R$29.00, considering 2,664 unnecessary office visits it is expected a savings of R$247,220.00/year

Admissions: 80 @ average cost of R$4,320.00 – savings of R$345,600.00/year

Potential savings (2002 base prices): R$667.412.00/year or R$3.76/beneficiary/month

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CONTACT:

 

FioCruz

FIONEWS – Informativo Mensal Fioprev

Instituto Oswaldo Cruz de Seguridade Social

Av. Brasil, 4.036 Grupos 300 a 316 – Rio de Janeiro- RJ

Brasil - Manguinhos - CEP 21.040-361

Phone +55 (21) 3865-0088

 

FONEMED Brasil
José Garcia

Avenida Angelica 2503 conj. 151
Brasil - Sao Paulo - CEP 01227-200

Phone: +55 (11) 3159-3476
jgarcia@fonemedbrasil.com.br