scholarly journals P017: A time-driven activity-based costing method to estimate health care costs in the emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S83
Author(s):  
S. Berthelot ◽  
M. Mallet ◽  
L. Baril ◽  
P. Dupont ◽  
L. Bissonnette ◽  
...  
Keyword(s):  
Emergency Department ◽  
Unit Cost ◽  
Emergency Physicians ◽  
Activity Based Costing ◽  
Process Maps ◽  
X Ray ◽  
Resource Unit ◽  
Care Activity ◽  
The Cost ◽  
Care Costs

Introduction: Poor physicians’ knowledge of health care costs has been identified as an important barrier to improving efficiency and reducing overuse in care delivery. Moreover, costs of tests and treatments estimated with traditional costing methods have been shown to be imprecise and unreliable. We estimated the cost of frequent care activities in the emergency department (ED) using the time-driven activity-based costing (TDABC) method. Methods: We conducted a TDABC study in the ED of the CHUL, Québec city (77000 visits/year). We estimated the cost of all potential care activities (e.g. triage) provided to adult patients with selected urgent (e.g. pulmonary sepsis) and non urgent (e.g. urinary tract infection) conditions frequently encountered in the ED. Following Lean management principles, process maps were developed by a group of ED care providers for each care activity to identify human resources, supplies and equipment involved, and to estimate the time required to complete each process. Resource unit cost (e.g. cost per minute of a nurse) and overhead rate were calculated using financial information from fiscal year 2015-16. Estimated cost of each care activity (e.g. chest X-ray) including physicians’ charges was calculated by summing overhead allocation and the cost of each process (e.g. disinfection of the X-ray machine) as obtained by multiplying the resource unit cost by the time for process completion. Results: Process maps were developed for 14 conditions and 68 ED care activities. We estimated the costs of activities (CAN$) related to nursing (e.g. urinalysis and culture triage ordering $14.70), clerk tasks (e.g. patient registration $3.40), physicians (e.g. FAST scan $20.90), laboratory testing (e.g. CBC $6.30), diagnostic imaging (e.g. abdominal CT scan $146.50), therapy (e.g. 5 mg of iv morphine $20.40), and resuscitation (rapid sequence intubation with ketamine and succinylcholine $146.40). Overall, emergency physicians’ charges, personnel salaries and overheads accounted for 38%, 22% and 16% of all ED care costs, respectively. Conclusion: Our results represent an important step toward increasing emergency physicians’ awareness on the real cost of their interventions and empowering them to adopt more cost-effective practice patterns.

scholarly journals Urgent Care Costs of Uncontrolled Asthma in Canada, 2004

2005 ◽  
Vol 12 (8) ◽  
pp. 435-436 ◽  
Author(s):  
Soo Jin Seung ◽  
Nicole Mittmann
Keyword(s):  
Emergency Department ◽  
Indirect Costs ◽  
Emergency Department Visits ◽  
Urgent Care ◽  
Uncontrolled Asthma ◽  
Physician Visits ◽  
Direct And Indirect Costs ◽  
Drug Treatments ◽  
The Cost ◽  
Care Costs

It has been more than a decade since Krahn evaluated the direct and indirect costs of asthma in Canada. Asthma is often uncontrolled and the cost of providing urgent care has not been determined. Hospitalizations, unscheduled physician visits, emergency department visits, drug treatments and ambulance rides are resources used by the uncontrolled asthmatic population, resulting in $162 million in costs annually. Improved control of asthma could decrease these costs.

ANALISIS BIAYA SATUAN METODE ACTIVITY BASED COSTING DALAM EVALUASI TARIF PELAYANAN KESEHATAN DI ERA JKN (Studi Kasus Pasien Stroke di Rumah Sakit Kristen Mojowarno)

2016 ◽  
Vol 26 (1) ◽  
pp. 79
Author(s):  
. Soewatoen
Keyword(s):  
Unit Cost ◽  
Indirect Costs ◽  
Activity Based Costing ◽  
Labor Costs ◽  
Stroke Patients ◽  
Severe Stroke ◽  
High Care ◽  
Mild Stroke ◽  
Christian Hospital ◽  
The Cost

Mojowarno Christian Hospital is an organization that is move in health services that produce multi-product, theratio of consumption of each product is different and significant indirect costs therefore needed to determine theservice tariff calculation of unit cost in the hospital with Activity Based Costing Method. The purpose of this studywas to determine the calculation of unit costs of care and outcomes of stroke patients fare calculation using theunit cost from Activity Based Costing method hospital compared with rates prevailing at the moment and ratesINA CBGs. This type of research is a qualitative case study. Based on calculations by the method of ActivityBased Costing obtained Unit Cost for Outpatient is Rp. 749.705, Unit Cost for Emergency Care Unit Mild Strokeis Rp 664.093;Medium Stroke Rp. 1.424.683, Severe Stroke Rp. 2.282.755,-. Unit Cost for Room type III MildStroke is Rp. 3.899.786, Medium Stroke Rp. 5.874.646, Severe Stroke Rp. 7.892.496; Unit Cost for Room type IIMild Stroke is Rp. 4.859.510, Medium Stroke Rp. 7.557.913, Severe Stroke Rp. 10.294.306; Unit Cost for Roomtype I Mild Stroke is Rp. 6.097.530, Medium Stroke Rp. 9.728.198, Severe Stroke Rp. 13.391.856; Unit Cost forVIP Room Mild Stroke is Rp. 10.953.150, Medium Stroke Rp. 18.240.533, Severe Stroke Rp. 25.540.906 ; UnitCost for High Care Unit Mild Stroke is Rp. 3.710.121, Medium Stroke Rp. 5.655.278, Severe StrokeRp. 9.477.309 and Unit Cost Intensive Care Unit Mild Stroke is Rp. 7.010.169, Medium Stroke Rp. 10.605.350,Severe Stroke Rp. 17.727.429,-.Each unit cost plus the cost of materials and direct labor costs, it can be seen thatthe cost of treatment of each disease severity have enough material price difference. It is because the higher theseverity of the disease makes the longer the treatment, the more use the service activities, and service facilities, itsmake the cost is higher. The comparison resoult showed that hospital rates prevailing at this time and the resultsof the calculation using the ABC method for stroke patients is higher than the rate of INA CBGs.

scholarly journals Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care

2020 ◽  
Vol 17 (21) ◽  
pp. 8085
Author(s):  
Eva Glaeser ◽  
Bart Jacobs ◽  
Bernd Appelt ◽  
Elias Engelking ◽  
Ir Por ◽  
...  
Keyword(s):  
Health Care Services ◽  
Public Hospital ◽  
Average Length ◽  
Unit Cost ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Activity Based Costing ◽  
Middle Income ◽  
The Public ◽  
The Cost

Knowing the cost of health care services is a prerequisite for evidence-based management and decision making. However, only limited costing data is available in many low- and middle-income countries. With a substantially increasing number of facility-based births in Cambodia, costing data for efficient and fair resource allocation is required. This paper evaluates the costs for cesarean section (CS) at a public and a Non-Governmental (NGO) hospital in Cambodia in the year 2018. We performed a full and a marginal cost analysis, i.e., we developed a cost function and calculated the respective unit costs from the provider’s perspective. We distinguished fixed, step-fixed, and variable costs and followed an activity-based costing approach. The processes were determined by personal observation of CS-patients and all procedures; the resource consumption was calculated based on the existing accounting documentation, observations, and time-studies. Afterwards, we did a comparative analysis between the two hospitals and performed a sensitivity analysis, i.e., parameters were changed to cater for uncertainty. The public hospital performed 54 monthly CS with an average length of stay (ALOS) of 7.4 days, compared to 18 monthly CS with an ALOS of 3.4 days at the NGO hospital. Staff members at the NGO hospital invest more time per patient. The cost per CS at the current patient numbers is US$470.03 at the public and US$683.23 at the NGO hospital. However, the unit cost at the NGO hospital would be less than at the public hospital if the patient numbers were the same. The study provides detailed costing data to inform decisionmakers and can be seen as a steppingstone for further costing exercises.

scholarly journals Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

2015 ◽  
Vol 8 (1) ◽  
pp. 165 ◽  
Author(s):  
Mahdi Javid ◽  
Mohammad Hadian ◽  
Hossein Ghaderi ◽  
Shahram Ghaffari ◽  
Masoud Salehi
Keyword(s):  
Unit Cost ◽  
Cost Price ◽  
Medical Services ◽  
Cost Calculation ◽  
Accounting System ◽  
Activity Based Costing ◽  
Hospital Managers ◽  
Cost System ◽  
Abc Method ◽  
The Cost

<p><strong>BACKGROUND:</strong> Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system.</p> <p><strong>OBJECTIVE:</strong> This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran.‎</p> <p><strong>METHODS:</strong> This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS.‎</p> <p><strong>RESULTS:</strong> The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the MAJOR COST COMPONENTS.</p> <p><strong>CONCLUSION:</strong> By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department.<strong></strong></p>

scholarly journals Calculation of Unit Cost School Information System Development using ABC (Activity Based Costing) Method

2020 ◽  
Vol 3 ◽  
pp. 307-313
Author(s):  
Muhammad Fahson Hakim ◽  
Ahmad Sirojun Nuha ◽  
Widya Aini Lathifah ◽  
M. Ainul Yaqin
Keyword(s):  
Information System ◽  
System Development ◽  
Unit Cost ◽  
Cost Calculation ◽  
Activity Based Costing ◽  
Cost Information ◽  
Goods And Services ◽  
Management Concepts ◽  
The Government ◽  
The Cost

In developing an information system the school must determine a strategy in its development. Look for managers who are reliable in making decisions that are oriented to reliable development. One of the proper management concepts is cost accuracy. Accuracy of charging costs on cost objects is very important for users of cost information. Beside the accuracy, it is also needed to find out the cost per unit needed in the information system. This is intended to have a price benchmark for the development of information systems in the future. In this study the unit cost calculation uses the ABC (Activity Based Costing) method which emphasizes the cost calculation for the activities involved. The allocation of costs is based on salary data from trusted institutions, namely the Pedoman Standard Minimal 2019 by INKINDO. The results of this study get a total cost value of 18.407.082,00while the cost of each complexity is 5,301.00 with the standard cost of procurement of goods and services issued by the government and several survey institutions.

scholarly journals Perhitungan Unit Cost Pengembangan Sistem Informasi Pondok Pesantren Dengan Metode ABC (Activity Based Costing)

2020 ◽  
Vol 5 (2) ◽  
pp. 205
Author(s):  
Muhammad Ainul Yaqin ◽  
Muhammad Bagus Wicaksono ◽  
Derida Elfraim Falahian ◽  
Eryan Rachman Hakim
Keyword(s):  
Information System ◽  
System Development ◽  
Unit Cost ◽  
Boarding Schools ◽  
Quantitative Approach ◽  
Cost Calculation ◽  
Activity Based Costing ◽  
Cost Information ◽  
Management Concepts ◽  
The Cost

The purpose of this study is to describe and calculate the unit cost in developing the information system for Islamic boarding schools. This research uses a descriptive-quantitative approach. Data collection methods are observation and documentation. The descriptive approach in this study is used to analyze and interpret the data from observations and documentation that have been collected, while the quantitative approach in this study is used to explain the nominal unit cost calculation using the ABC (Activity Based Costing) method. In every development of an information system, the costs required are quite a lot and have several complex parameters, so that one of the management concepts is needed, namely cost accuracy. This becomes important for users of cost information to determine the cost effectiveness used by each unit as well as a reference price in further information system development, in this case the cost of developing an information system for Islamic boarding schools. The method we use in calculating unit costs is ABC (Activity Based Costing), where the calculation system charges costs for each activity involved before calculating product costs. The number of activities in developing a software or information system makes this method suitable to be applied in cost accuracy. The standard benchmark for the cost of procuring goods and services in this study is in accordance with government regulations and several observations, while the amount of salary costs follows the 2019 Minimum Standard Guidelines issued by INKINDO (National Association of Indonesian Consultants). The results of this study show that in developing the information system for Islamic boarding schools, the total cost required is Rp. 79,100,000.00 with a unit cost of Rp. 17,673,607.35.

scholarly journals Determining the Cost of Care for U.S. Healthcare Providers: A Hybrid Approach

2020 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Mohamed Abualhaija
Keyword(s):  
Unit Cost ◽  
Hybrid Approach ◽  
Healthcare Providers ◽  
Cost Of Care ◽  
Charge Ratio ◽  
Activity Based Costing ◽  
Relative Value ◽  
Efficiency And Effectiveness ◽  
Costing System ◽  
The Cost

Many US healthcare providers can’t easily calculate the cost of treating patients. They use simple calculations such as the cost-to-charge ratio (CCR) which Medicare uses for reimbursement purposes and the ratio-of-cost-to-charge (RCC) which allocates costs to patients based on revenue generated from revenue centers. Healthcare providers are unique, provide different services, and use different resources for treatments. A-one-size-fits-all costing system can’t work for all sizes and different specialty practices. Scholars suggested many costing methods that can be used in different healthcare practices, such as the unit cost analysis, the standard costing method, the gross-costing method, the chart of accounts, the resource-based relative value units (RBRVS), the step-down cost accounting (SDCA), and the activity-based costing (ABC). The purpose of this article is to recommend a costing method that can be easily learned and applied by different size healthcare providers. The proposed hybrid costing approach can help providers calculate the cost of care by capturing the cost of routine and standard exams, treatments, services, and procedures using the process costing system, and capture all other costs that are unique to each patient using the job order costing system. Adequately determining the cost of care will help healthcare leaders improve planning and budgeting for target income and achieve organizational efficiency and effectiveness.

COST ANALYSIS OF CLINICAL PRACTICE NURSING PROFESSION STUDENTS WITH ACTIVITY BASED COSTING (ABC) METHOD IN Dr. SOEWANDHI HOSPITAL SURABAYA EAST JAVA

2017 ◽  
Vol 1 (2) ◽  
pp. 128
Author(s):  
M Hasinuddin ◽  
Nuh Huda ◽  
Abdul Wahid
Keyword(s):  
Clinical Practice ◽  
Professional Practice ◽  
Unit Cost ◽  
Educational Institutions ◽  
Activity Based Costing ◽  
Practice Nurses ◽  
Professional Nurses ◽  
Abc Method ◽  
The Cost ◽  
The Impact

Background and objectives. During this time the unit cost of clinical practice in hospitals that practice becomes a vehicle which has not been done calculation costing more Clinical practice based on estimates, propriety and comparison with the cost of clinical practices from other hospitals. The costing is sometimes caused problems. Currently the cost of student practice in teaching hospitals varies between Rp. 300,000 - Rp. 500,000 / person / month. The problem that exists is how the unit cost and how much it costs the right based on unit cost and other considerations that apply to students practice at the Hospital Clinic as a vehicle for clinical practice. The purpose of this study to determine the unit cost and set the cost of professional practice of nurses that will be proposed applicable professional nurses students at Hospital.Method. This research was a descriptive observational study by conducting a case study in the dr. Soewandhi hospital East Java. Calculation of unit cost carried by Activity Based Costing (ABC), costing more to do content analysis after conducting focus group discussions, as well as other considerations.Research result. The results using the ABC method showed that the unit cost to the cost of professional practice nurses in the hospital Dr. Soewandhi Surabaya is Rp. 460,000, - / month / person, while the cost of practice set by the RS Dr. Soewandhi is Rp. 1.200.000, - / month / person. There is a practice of the profession excess costs Rp. 740,000, -. RS Dr. Surabaya Soewandhi practice fees apply without using a standard based on the unit cost accordingly. Some educational institutions felt the cost was very heavy so the impact to the cancellation of the filing of the professional nurses student practice.Conclusions and recommendations. The hospital used a professional students practice nurses should use the standard fees in accordance with needs through precise calculations that the fees charged to students through educational institutions in accordance with the appropriate calculations.Keyword: ABC system - Profession nurses - Fee Practices

Measuring cost in the value equation using time-driven activity-based costing (TDABC) at The University of Texas MD Anderson Cancer Center, Division of Radiation Oncology.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18305-e18305
Author(s):  
Nicholas D. Olivieri ◽  
Benjamin D. Frank ◽  
John D. Calhoun ◽  
Alexis B. Guzman ◽  
Justin N. Onwenu ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Oncology ◽  
Treatment Modality ◽  
Cancer Center ◽  
Activity Based Costing ◽  
Site Specific ◽  
Process Maps ◽  
Disease Site ◽  
Md Anderson ◽  
The Cost

e18305 Background: The cost of a full cycle of radiation therapy at MD Anderson Cancer Center has not been determined using a bottom-up measurement approach. Due to the complexity and variation in clinical processes, typical costing strategies do not provide the level of detail necessary to evaluate the value equation, defined as outcomes over cost. To address this limitation, we designed and implemented a practice-wide Time-Driven Activity-Based Costing (TDABC) strategy to capture our total direct cost of care for all treatment modalities within each of 9 disease site-specific services. Methods: Process maps were created for each of the 9 disease site-specific services. Care delivery times were captured by treatment modality for each service as determined by multidisciplinary teams routinely performing each step of the process. The data were entered into a standardized tool, which calculated step costs based upon capacity cost rates for each human resource. The costing tool also calculated total direct labor costs for specific treatment plans based on modality, complexity, and fractionation. Results: The analysis took six months to complete and required the use of approximately 1,000 administrative hours, 250 physician hours, 250 clinical staff hours and 100 medical physics hours. Approximately 17 process maps were created for each of the 9 services with each process map receiving further analysis based upon radiation treatment modality. As a result of observed variation in costs between disease-site services, best practices were identified and 15 standardization opportunities were discovered. Additionally, the cost-benefit analysis between high profile modalities within each disease-site service, such as Proton Therapy and Intensity Modulated Radiation Therapy (IMRT) on the Head and Neck service, were easier to complete. Conclusions: Time-Driven Activity-Based Costing is a valid method for calculating direct costs in a large academic radiation oncology practice. Standardized clinical outcome data can be used to complete the value equation and ultimately provide insight for better clinical and administrative decision making.

scholarly journals MODEL ACTIVITY BASED COSTING PADA SEKOLAH MENENGAH KEJURUAN

2018 ◽  
Vol 15 (1) ◽  
pp. 1-12
Author(s):  
Sri Sumardiningsih ◽  
Sugiharsono Sugiharsono ◽  
Mimin Nur Aisyah ◽  
Aula Ahmad Hafidh Syaiful Fikri
Keyword(s):  
Data Analysis ◽  
Teaching And Learning ◽  
Unit Cost ◽  
Activity Based Costing ◽  
Descriptive Data ◽  
Education Services ◽  
Unit Costs ◽  
Cost Of Education ◽  
Traditional Costing ◽  
The Cost

Penelitian ini bertujuan mengetahui alokasi dana pendidikan ke seluruh aktivitas yang ada di sekolah, unit cost pelayanan pendidikan tiap siswa di setiap tingkat dan paket keahlian, dan perbandingan unit cost pelayanan pendidikan di setiap tingkat dan paket keahlian dihitung dengan ABC dan metode Traditional Costing. Objek penelitian yakni unit cost pelayanan pendidikan di SMK Negeri Yogyakarta 2016/2017. Pengumpulan data melalui wawancara dan dokumentasi, FGD. Menggunakan analisis data deskriptif. Hasil menunjukkan alokasi dana terbesar untuk biaya aktivitas belajar mengajar yaitu 55,77%, paling rendah adalah biaya kegiatan manajemen sekolah 6,20%, dan aktivitas  lainnya sekitar 9%. Unit cost per siswa dihitung dengan ABC dilihat antar Paket Keahlian berbeda-beda, berkisar dari Rp 1.168.513 sampai Rp 1.424.116. Unit cost dengan Traditional Costing dibanding dengan ABC ada yang termasuk kategori undercosted dan overcosted. Biaya yang termasuk kategori overcosted adalah seluruh paket keahlian di kelas X dan kategori undercosted adalah pada seluruh paket keahlian di kelas XI dan XII. The cost of education services for each student in each level and the package of expertise, and the cost of education services at each level and skills packages are calculated by ABC and Traditional Costing methods. The object of this study is the unit of cost of education services in Yogyakarta 2016/2017 State Vocational School. Data collection through interview and documentation techniques, FGD. Data analysis using descriptive data analysis. The results of the funding for teaching and learning activities are 55.77%, 6.20% of the lowest cost of school management activities, and other activities around 9%. Unit cost per student is calculated with seen ABC between different skill packages, ranging from Rp 1,168,513 to Rp 1,424,116. Unit costs with Traditional Costing compared to ABC are categorized as undercosted and overcosted. Costs included in the overcosted category are all skill packages in X and undercosted categories in all skills packages in class XI and XII.

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