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El coste financiero del fraude sanitario en 2014

LONDRES, March 25, 2014 /PRNewswire/ --


- Los fraudes y errores cuestan al sector sanitario global 487.000 millones de dólares (313.00 millones de libras) al año

  • Desde 2008 las pérdidas globales medias por error y fraude en el sector sanitario han aumentado un 25%, desde el 5,59% de gasto al 6,99%
  • Reducción en pérdidas por fraude y error de hasta el 40% posibles en un año, liberando hasta 195.000 millones de dólares (125.000 millones de libras) globalmente
  • Las tasas de pérdidas medias globales sugieren pérdidas en el servicio nacional de salud del Reino Unido de 7.000 millones de libras

El mundo está perdiendo unos 487.000 millones de dólares por fraudes y errores anualmente según el nuevo informe "The Financial Cost of Healthcare Fraud 2014" de BDO LLP, la firma de consultoría y asesoría empresarial en asociación con el Centre for Counter Fraud Studies de la Universidad de Portsmouth.

Los hallazgos muestran que las pérdidas medias globales dentro del sector sanitario han ascendido desde 2008 un 25%, al 6,99%. Cuando se toman como un porcentaje del gasto sanitario global de 6,97 billones de dólares (4,48 billones de libras) esto es igual a 487.000 millones de dólares (313.000 millones de libras) perdidos en un año equivalente a:

  • Más de tres veces el presupuesto del sistema nacional de salud del Reino Unido para 2011/12
  • Dos veces y media el gasto sanitario total de Canadá para 2011
  • Casi un quinto del gasto sanitario total de Estados Unidos para 2011 y más del 27% del gasto sanitario total de los países de la Unión Europea para el mismo periodo  

Afortunadamente los ejercicios de medición del fraude han mostrado que es posible reducir significativamente las pérdidas con una reducción del 40% en 12 meses, lo que se considera una expectativa muy razonable. Esto a su vez supondría un aumento de los recursos sanitarios globales de 195.000 millones de dólares (125.000 millones de libras).

Estudio de caso

En el servicio nacional de salud del Reino Unido (la segunda mayor organización del mundo) entre 1998 y 2006 las pérdidas se redujeron hasta el 60%. Las estadísticas del National Fraud Authority Indicator 2013 del Reino Unido sugieren que el fraude en el sistema nacional de salud fueron de 229 millones de libras en 2013; sin embargo, aplicando la tasa de pérdida de porcentaje medio global se sugiere que si el sistema nacional de salud estaba en línea con el resto del mundo, sería más probable una cifra cercana a los 7.000 millones de libras. Aceptar la cifra de 229 millones de libras sería aceptar que el sistema nacional de salud está haciéndolo más de 30 veces mejor que el resto del mundo en la prevención y detección de fraudes y errores. El doctor David Evans, director de Financiación de sistemas sanitarios para la Organización Mundial de la Salud (OMS) describe las conclusiones del informe como "convincentes" en su prólogo, mientras que el doctor Simon Peck, fundador del Health Insurance Counter Fraud Group (HICFG), un grupo industrial del Reino Unido de 29 compañías de seguros sanitarios líderes, escribe en su prefacio que "los que tienen el poder de marcar la diferencia" deberían leer el informe.  

Jim Gee, director de Counter Fraud Services en BDO LLP, añadió:

"La crisis financiera global ha tenido un importante impacto en la capacidad de los gobiernos, corporaciones y personas para cubrir el creciente coste de sus requisitos sanitarios. Estas restricciones presupuestarias podrían, sin embargo, mejorarse ampliamente con un esfuerzo concertado para medir, gestionar y minimizar el coste de los fraudes y errores dentro de las organizaciones relevantes, particularmente si se respaldada por requisitos legislativos. Nuestra estimación conservadora es que abordando este problema seriamente, las organizaciones sanitarias globales podrían liberar hasta 195.000 millones de dólares que actualmente se pierden. Esto podría suponer una diferencia material para las vidas de millones de personas en todo el mundo".

El informe completo "BDO Financial Cost of Healthcare 2014" puede consultarse en http://www.bdo.co.uk/services/forensic-accounting/fraud-and-financial-investigations/counter-fraud-services

Acerca del informe

El informe Financial Cost of Healthcare Fraud 2014 renueva la investigación realizada primero en 2009 y repetida en 2011, cotejando la última información precisa y estadísticamente válida de todo el mundo sobre el coste financiero real de los fraudes y errores del sistema sanitario (frente al coste del fraude detectado o notificado). En total, el informe evalúa 92 ejercicios de medición de pérdidas independientes que cubren 14 tipos distintos de gasto sanitario, haciendo un total de más de 2,99 billones de dólares (1,93 billones de libras) en 33 organizaciones de 6 países. Los datos que forman sus conclusiones se sitúan en la mayor base de datos de medición de pérdidas del mundo con datos recogidos de más de 15 años. Los datos se derivan de ejercicios de medición de pérdidas precisos y estadísticamente válidos, no solo lo que se ha detectado o notificado, que es solo un pequeño porcentaje del coste total.  

El informe representa otro resultados de la colaboración fructífera entre BDO LLP, la principal firma de servicios de asesoría contable y empresarial, y el Centre for Counter Fraud Studies de la Universidad de Portsmouth (CCFS), el principal centro de investigación del fraude de Europa.

Nota a los redactores

Acerca de BDO

El aprovisionamiento de servicios dentro de la red BDO internacional de firmas miembro independientes ("la red BDO") está coordinada por el Brussels Worldwide Services BVBA, una compañía de responsabilidad limitada incorporada en Bélgica con su posición estatutoria en Bruselas.  

La BDO International Limited (entidad gobernadora de la red BDO), Brussels Worldwide Services BVBA y las firmas miembros son entidades legales independientes y no tienen responsabilidad de los actos u omisiones de las otras entidades. Nada en las disposiciones o normas de la red BDO contribuirá o implicará una relación de agencia o una asociación entre BDO International Limited, Brussels Worldwide Services BVBA y/o las firmas miembro de la red BDO. 

BDO es el nombre comercial de la red BDO y de cada una de las firmas miembro de BDO.  

Los ingresos procedentes de tasas combinados de todas las firmas miembro BDO, incluyendo los miembros de sus exclusivas alianzas, fueron de 6.450 millones de dólares en 2013. La red global ofrece servicios de asesoría en 147 países, con más de 56.000 personas trabajando en 1.264 oficinas en todo el mundo.

Contactos en el Reino Unido
Jim Gee, BDO LLP
Tel: +44(0)20-7893-2830
E-mail: [email protected]

http://www.bdo.co.uk/press
http://twitter.com/BDOaccountant

Ged Brumby, Smithfield Consultants
Tel: +44(0)20-7903-0674
Móvil: +44(0)7540-412-301
E-mail: [email protected]


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