Análise de macro e micro custeio na conservação e manutenção de cadáveres humanos para o ensino de anatomia em uma universidade do Nordeste do Brasil

Abstract

INTRODUCTION: The use of human cadavers is indispensable for the practical teaching of anatomy and the training of healthcare professionals. However, the preservation of these bodies, generally performed through the fixation technique using formaldehyde, requires significant investments from higher education institutions. Maintenance involves a series of costs related to infrastructure, the acquisition of personal protective equipment (PPE), chemical supplies, and strict compliance with biosafety regulations (such as NR-32) to protect the health of students and professionals. OBJECTIVE: To analyze the direct and indirect costs associated with the preservation and maintenance of human cadavers for anatomy teaching at a Federal University in Northeast Brazil, using combined macro and micro-costing techniques. METHOD: This is a descriptive observational study of economic evaluation, with a quantitative approach and both a documentary and field design, conducted at the Anatomy Laboratory of University. The study employed combined methodologies: micro-costing to estimate the direct and variable costs of the fixation procedure (tracking supplies and work time measured by direct observation); and macro-costing to calculate fixed, indirect, and structural depreciation costs. Additionally, a linear apportionment of the institution's administrative infrastructure contracts (such as cleaning and security) was applied to estimate the institutional expenses attributable to cadaveric custody. RESULTS: The micro-costing revealed that the initial fixation procedure has a cost of R$ 669.82 per cadaver, an amount that encompasses materials, transportation, and professional fees. In the context of internal macro-costing, the cost of custody and continuous maintenance was estimated at R$ 415.01 per month, totaling R$ 5,395.13 annually. The apportionment of institutional infrastructure contracts added R$ 1,485.57 per cadaver per year. Integrating all approaches, the total cost for the first year of using the cadaver was estimated at R$ 7,550.51. The analysis showed that approximately 91.1% of this total cost stems from structural and continuous maintenance expenses, leaving only 8.9% related to the initial process of receiving and fixing the specimen. CONCLUSION: The combination of micro and macro-costing methodologies enabled a realistic and comprehensive understanding of the expenses involved in obtaining and preserving cadavers for academic purposes. It is clear that long-term structural maintenance represents the largest share of the financial burden. These data are fundamental to assist institutions in budgetary planning and to guide future agreements on cost-sharing among universities that use the anatomical collection. Keywords: Anatomy. Health Expenditures. Formaldehyde. University. Tissue Preservation. Materials Management.