Banca de QUALIFICAÇÃO: HEULER SOUZA ANDRADE

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : HEULER SOUZA ANDRADE
DATE: 28/10/2021
TIME: 14:30
LOCAL: Videoconferência
TITLE:

EVALUATION OF THE COSTS OF THE COLD CHAIN MUNICIPAL INSTANCE CONSERVATION OF IMMUNOBIOLOGICALS

KEY WORDS:

Health evaluation; Cold chain; Cost analysis

PAGES: 59
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Immunobiologicals are thermolabile substances, which means that they need to be
kept at an ideal temperature in order to preserve their characteristics and properties.
In Brazil, the Ministry of Health, through the National Immunization Program, has a
technical administrative structure, responsible for all regulation of the immunobiological
conservation process, called Rede de Cold. It also has a logistical structure that
involves storage, conservation, handling, transport and distribution, to ensure the
conservation of these substances from the producing laboratory to the user, called the
Cold Chain. Like any service provided by any organization, maintaining the quality of
the Cold Chain has a financial cost that needs to be measured and evaluated in order
to achieve an efficient allocation of resources. Knowing and evaluating the costs of the
Cold Chain of a municipality is a necessary condition for improving the quality of its
activities, as the results of the evaluation may, in addition to indicating the level of
performance of this service, serve as a subsidy for a process of change in its
management and organization. This study aims to evaluate the costs of the Cold Chain
of vaccine conservation in a municipality in the state of Minas Gerais. This is an
economic evaluation survey focused on cost analysis, carried out between 2020 and

2022. The study was divided into two stages: In the first stage, a checklist of cost-
generating activities at the municipal level was developed and validated of the Cold

Chain, in order to have a more accurate description of the resources consumed in the
process of conservation of immunobiologicals. Bibliographic references, ordinances,
technical standards, manuals, reports and dissemination materials on the Cold Chain
were analyzed. Based on the logical model of the Cold Chain, developed by Oliveira
et al. (2020) 20 activities were identified, divided into three components: Transport and
Receiving (6 activities); Storage and Handling (12 activities); Supervision and Ongoing
Education (2 activities). To validate the checklist, the Delphi technique was used in a
process carried out entirely online. Twenty-three judges participated, including doctors,
masters and specialists working at state, regional and municipal health levels. The
content validation index and Cronbach's alpha coefficient were calculated to analyze
the internal consistency of the checklist. After the validation process, the checklist was
composed of 7 activities in the Transport and Receiving component, 18 in the activities
in the Storage and Handling component and 2 activities in the Supervision and
Continuing Education component. Considering all components, the checklist's total

content validation index was 92.3%. Total internal consistency obtained a Cronbach's

alpha coefficient value of 0.9534. In the second stage, a study of the costing of the
Cold Chain will be carried out. The perspective of SUS as a funder of FC was
considered, including direct medical and non-medical costs. The year 2021 was
adopted as the timeframe and the six-month period as the timeframe for the analysis.
The unit of analysis was the Cold Chain municipal instance. In order to investigate the
costing, the ABC Costing method will be used, constituted in this study by five phases:

1 – elaboration of the theoretical model of the Cold Chain; 2 – identification of cost-
generating activities; 3 – survey of committed expenses; 4 – Measurement and

valuation of costs; 5 – Sensitivity analysis. At the end of the study, it is expected, first,
to find conditions to assess the costs of the Cold Chain in the city. Later, it is expected
to be able to estimate the costs of the Cold Chain so that they can contribute to the
management of the service.

BANKING MEMBERS:
Presidente - 1347706 - ALBA OTONI
Externa à Instituição - FERNANDA PENIDO MATOZINHOS - UFMG
Externo à Instituição - ALEXANDER ITRIA - UFSCAR