A Package of Integrated Audit Trails Applied to Orthoses, Prostheses and Special Materials (OPME) in the SUS: Data Oriented to the Big Data Architecture of the FiscalizaSUS Platform
Health audit, SUS, orthoses, prostheses and special materials, Big Data.
Brazil is a country of continental size, with one of the largest populations in the world, also known internationally for its cultural diversity and which, throughout its history, has undergone countless transformations. A significant milestone, in terms of laws, was the Federal Constitution of 1988. This is the current Constitution of Brazil, also known as the “Citizen Constitution”, as it establishes several fundamental rights, such as freedom of expression, religious freedom and those related to work, social security, education, health and social assistance. Among the advances achieved by the 1988 Constitution is the establishment of the Unified Health System (SUS), a milestone in Brazilian public health, responsible for the universal provision of health services and the coordination of health policies at the national level. With a healthcare system whose core principle is universal and comprehensive access to healthcare, it was necessary to define mechanisms capable of monitoring the application of resources allocated to this sector. To this end, the National Audit Department of the Unified Health System (DENASUS) was created. In 2024, the Budget Guidelines Law (LDO) provided for a budget of R$231 billion for healthcare to carry out activities in the areas of governance and management of Public Policies, Programs and Projects that implement the execution of the SUS. Given its significant budget, its healthcare demands and the significant regional asymmetries in Brazil, the SUS, in all its complexity, must always seek to ensure efficiency in the allocation of public resources. This issue requires strategies that also permeate the management of information in healthcare, which, due to the nature of the SUS, produces large volumes of data on a daily basis. In view of the need to improve control mechanisms for public health spending, the FiscalizaSUS project was developed through technical cooperation between the Advanced Center for Technological Innovation (NAVI) of the Federal Institute of Rio Grande do Norte (IFRN) and the National Audit Department of the SUS (DENASUS) of the Brazilian Ministry of Health. This technical cooperation also includes the Laboratory for Technological Innovation in Health (LAIS) of the Federal University of Rio Grande do Norte (UFRN) and the Federal Public Prosecutor's Office of Rio Grande do Norte (MPF/RN). In this context, the objective of this master's research is to develop a package of integrated audit trails for the SUS, applied to orthoses, prostheses and special materials (OPME). This package will be guided by a Big Data architecture with the purpose of helping DENASUS auditors identify possible nonconformities, which may indicate signs of fraud, illegalities or irregularities. This scope includes the relationship between company partners, beneficiaries of the Federal Government's income transfer program, public employees and companies that participate in transactional processes that include orthoses, prostheses and special materials. In addition, it will be necessary to structure and qualify the data that will make up the OPME audit content in the Big Data architecture and create a visualization layer to facilitate the auditors' work.