scholarly journals A Time-Driven Activity-Based Costing Approach for Identifying Variability in Costs of Childbirth Between and within Types of Delivery

2021 ◽  
Author(s):  
Kathia Dubron ◽  
Mathilde Verschaeve ◽  
Filip Roodhooft
Keyword(s):  
Health Care Providers ◽  
Care Providers ◽  
Education Attainment ◽  
Activity Based Costing ◽  
Process Maps ◽  
Process Improvements ◽  
Personnel Costs ◽  
Parity Number ◽  
The Cost ◽  
Capacity Cost

Abstract Background Recently, time-driven activity-based costing (TDABC) is put forward as an alternative, more accurate costing method to calculate the cost of a medical treatment because it allows the assignment of costs directly to patients. The objective of this paper is to demonstrate how the overall cost of childbirth at the maternity department can be calculated by implementing a TDABC analysis. In addition, this study outlines how this costing method can be utilized to provide insights into how patient and disease characteristics drive variability within childbirth cost. Through the use of process mapping, TDABC allows to exactly identify which activities and corresponding resources are impacted by these characteristics, leading to a more detailed understanding of childbirth cost.Methods Process maps were developed for two types of childbirth, vaginal delivery (VD) and caesarean section (CS). Costs were obtained from the financial department and capacity cost rates were calculated accordingly. Results Overall, the cost of childbirth equals €1894,12 and is mainly driven by personnel costs (89,0%). Monitoring after birth is the most expensive activity on the pathway, costing €1149,70. Significant cost variations between type of delivery were found, with VD costing €1808,66 compared to €2463,98 for a CS. Prolonged clinical visit (+33,3 min) and monitoring (+775,2 min) in CS were the main contributors to this cost difference. Within each delivery type, age, parity, number of gestation weeks and education attainment were found to drive cost variations. In particular, for VD an age >25 years, nulliparous, gestation weeks > 40 weeks and higher education attainment were associated with higher costs. Similar results were found within CS for age, parity and number of gestation weeks.Conclusions TDABC is a valuable approach to measure and understand the variability in costs of childbirth and its associated drivers over the full care cycle. Accordingly, these findings can inform health care providers, managers and regulators on process improvements and cost containment initiatives.

scholarly journals A time-driven activity-based costing approach for identifying variability in costs of childbirth between and within types of delivery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathia Dubron ◽  
Mathilde Verschaeve ◽  
Filip Roodhooft
Keyword(s):  
Health Care Providers ◽  
Care Providers ◽  
Education Attainment ◽  
Activity Based Costing ◽  
Process Maps ◽  
Process Improvements ◽  
Personnel Costs ◽  
Parity Number ◽  
Cohort Study Design ◽  
The Cost

Abstract Background Recently, time-driven activity-based costing (TDABC) is put forward as an alternative, more accurate costing method to calculate the cost of a medical treatment because it allows the assignment of costs directly to patients. The objective of this paper is the application of a time-driven activity-based method in order to estimate the cost of childbirth at a maternal department. Moreover, this study shows how this costing method can be used to outline how childbirth costs vary according to considered patient and disease characteristics. Through the use of process mapping, TDABC allows to exactly identify which activities and corresponding resources are impacted by these characteristics, leading to a more detailed understanding of childbirth cost. Methods A prospective cohort study design is performed in a maternity department. Process maps were developed for two types of childbirth, vaginal delivery (VD) and caesarean section (CS). Costs were obtained from the financial department and capacity cost rates were calculated accordingly. Results Overall, the cost of childbirth equals €1894,12 and is mainly driven by personnel costs (89,0%). Monitoring after birth is the most expensive activity on the pathway, costing €1149,70. Significant cost variations between type of delivery were found, with VD costing €1808,66 compared to €2463,98 for a CS. Prolonged clinical visit (+ 33,3 min) and monitoring (+ 775,2 min) in CS were the main contributors to this cost difference. Within each delivery type, age, parity, number of gestation weeks and education attainment were found to drive cost variations. In particular, for VD an age >  25 years, nulliparous, gestation weeks > 40 weeks and higher education attainment were associated with higher costs. Similar results were found within CS for age, parity and number of gestation weeks. Conclusions TDABC is a valuable approach to measure and understand the variability in costs of childbirth and its associated drivers over the full care cycle. Accordingly, these findings can inform health care providers, managers and regulators on process improvements and cost containment initiatives.

Policy on the Development of Immunization Tracking Systems

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 927-927
Author(s):  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Tracking Systems ◽  
Public And Private ◽  
Immunization Status ◽  
Immunization Rates ◽  
Specialized Hardware ◽  
Public And Private Cooperation ◽  
The Cost

The American Academy of Pediatrics in its role as advocate for children supports public and private cooperation in the development of immunization tracking systems (ITSs) insofar as they benefit children. All ITSs as they are developed: • Should prospectively articulate their goals and desired outcomes, including documenting immunization status and the mechanics of immunization, increasing rates of immunization, decreasing cost of immunization, and facilitating immunization opportunities; • Must accurately document each child's current immunization status; • Must preserve children's and their health care provider's right to confidentiality; • Should ensure that data will be available to health care providers 24 hours a day, 7 days a week, so that health care providers can take advantage of all opportunities to immunize; • Should ensure that data will not be used for sanctions against health care providers; • Must ensure that data input and access mechanisms enable providers to supply and access data easily, without having to purchase specialized hardware or expensive software; input and access software mechanisms need to enable all providers to supply data to and retrieve data from the ITS; • Should entitle health care providers to be reimbursed or the cost of providing data to the ITS; • Must ensure that data reflecting evidence of incomplete immunizations will not be used to deny a child access to care or eligibility for benefits by any insurance plan; • Must be studied and/or evaluated to determine their effectiveness at increasing immunization rates and decreasing costs; if such systems do not fulfill these goals, they should be eliminated; and

scholarly journals Visual process maps to support implementation efforts: a case example

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Jennifer Kononowech ◽  
Zach Landis-Lewis ◽  
Joan Carpenter ◽  
Mary Ersek ◽  
Robert Hogikyan ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Process Mapping ◽  
Care Providers ◽  
Term Care ◽  
Goals Of Care ◽  
Process Maps ◽  
Time Burden ◽  
Centered Care

Abstract Background Process mapping is often used in quality improvement work to examine current processes and workflow and to identify areas to intervene to improve quality. Our objective in this paper is to describe process maps as a visual means of understanding modifiable behaviors and activities, in this case example to ensure that goals of care conversations are part of admitting a veteran in long-term care settings. Methods We completed site visits to 6 VA nursing homes and reviewed their current admission processes. We conducted interviews to document behaviors and activities that occur when a veteran is referred to a long-term care setting, during admission, and during mandatory VA reassessments. We created visualizations of the data using process mapping approaches. Process maps for each site were created to document the admission activities for each VA nursing home and were reviewed by the research team to identify consistencies across sites and to identify potential opportunities for implementing goals of care conversations. Results We identified five consistent behaviors that take place when a veteran is referred and admitted in long-term care. These behaviors are assessing, discussing, decision-making, documenting, and re-assessing. Conclusions Based on the process maps, it seems feasible that the LST note and order template could be completed along with other routine assessment processes. However, this will require more robust multi-disciplinary collaboration among both prescribing and non-prescribing health care providers. Completing the LST template during the current admission process would increase the likelihood that the template is completed in a timely manner, potentially alleviate the perceived time burden, and help with the provision of veteran-centered care.

Implementation of Time-Driven Activity-Based Costing System in the Manufacturing Industry

2020 ◽  
pp. 272-283 ◽  
Author(s):  
Ahmet Özcan
Keyword(s):  
Manufacturing Industry ◽  
Business Environment ◽  
Activity Based Costing ◽  
Strategic Decisions ◽  
Quality Cost ◽  
Goods And Services ◽  
Costing System ◽  
The Cost ◽  
Capacity Cost

In the current business environment, the costing system used within the firms has prominent impact on strategic decisions. High-quality cost data significantly increases the quality of firms' strategic decisions. The activity-based costing system has failed to satisfy the needs of firms operating in the competitive economic environment. The time-driven activity-based costing system is the developed version of activity-based costing system. Time-driven activity-based costing system is one of the most sophisticated costing systems that enable firms to accurately calculate the cost of goods and services. Time-equations are used in time-driven activity-based costing system to estimate the time consumed by each activity. This chapter aims to discuss main dynamics of time-driven activity-based costing system and provides an illustration of this costing system in the manufacturing industry. The case study demonstrates that time-driven activity-based costing system is useful in calculating idle capacity cost.

scholarly journals Improving Access to Cancer Treatments: The Role of Biosimilars

2017 ◽  
Vol 3 (5) ◽  
pp. 596-610 ◽  
Author(s):  
Rakesh Chopra ◽  
Gilberto Lopes
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Health Care Providers ◽  
Cost Effective ◽  
Cancer Therapies ◽  
Care Providers ◽  
Cancer Treatments ◽  
Reference Drug ◽  
Effective Use ◽  
The Cost

Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).

Australian Health Care Workers Use of a Telephone Advice Line

2001 ◽  
Vol 7 (3) ◽  
pp. 70
Author(s):  
Patrick G. M. Bolton ◽  
Sharon M. Parker ◽  
Jag Chera
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Information Service ◽  
Target Population ◽  
Care Providers ◽  
Australian Health ◽  
Care Workers ◽  
Telephone Advice ◽  
The Cost ◽  
Area Health

An evaluation of the Health Resource Line (HRL), a telephone information service for use by General Practitioners and Area Health employees in Northern and Central Sydney Area Health Services, was conducted following an eight month pilot. This evaluation found that no more than half of the target population were aware of the service, and that fewer than a third of these had trialed the service. This is consistent with the experience in other published trials of this kind. The experience of health care providers using the service was generally positive, but despite this, overall levels of use were low and declined after an initial peak. The low level of use brings into question the cost effectiveness of such a service and the need for possible alternatives.

Budgetbereinigung zwischen Kollektiv- und Selektivvertrag: ökonomische Aspekte aus wettbewerblicher Sicht / Selective Contracting and Collectively Financed Fund: The Way of Appropriate Adjustment

2012 ◽  
Vol 232 (4) ◽  
Author(s):  
Jürgen Zerth ◽  
Stefanie Daum
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cost Sharing ◽  
Care Providers ◽  
Commitment Strategy ◽  
Dynamic Perspective ◽  
The Cost ◽  
Static World ◽  
Selective Contracts ◽  
Method Of Adjustment

SummaryThe extraction of a selective contract from a collectively financed fund needs an appropriate method of adjustment. This is necessary as long as the fund guarantees basic benefits, irrespective of the contractual form of service provision. In this context externalities arise which may not be internalized by the partner of a selective contract.We look at externalities in the context of a collectively financed fund where insurers and health care providers can contract forms of managed care that need an adjustment scheme.We show that in a first-best static world, unique reimbursement schemes between collective and selective contracts are appropriate. From a dynamic perspective problems of externalities between collective and selective contracts increase due to the requirement of an enduring commitment scheme between the health care providers and the cost-payers. But some simple form of cost-sharing ideas in which the patient is also involved can help to achieve a pareto-optimal equilibrium. This commitment strategy will be easier to organise if the selective contract is connected with a process innovation. Altogether, the dynamic commitment strategy may only work if health care providers as well as cost-payers compete actively.

Making the Case for a Nurse-Led Vascular Access Team Utilizing a Quality Assurance Conceptual Framework

2009 ◽  
Vol 14 (2) ◽  
pp. 77-82 ◽  
Author(s):  
Amanda L. Beerman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Financial Burden ◽  
Central Venous Access ◽  
Venous Access ◽  
Care Providers ◽  
Quality Of Patient Care ◽  
The Cost ◽  
Venous Access Devices

Abstract The cost of complications of central venous access devices (CVADs) in today's health care setting is creating a financial burden, increasing the expenditures of resources, and consuming the time of health care providers to resolve. As the roles of nurses continue to evolve, nurses may be in a position to recognize and prevent many of these complications. This paper proposes a conceptual model to address the issues related to caring for and monitoring CVADs, while reducing complications and increasing quality of patient care.

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