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. 2022 Jan;37(1):189-201.
doi: 10.1002/hpm.3320. Epub 2021 Sep 9.

Time-driven activity-based costing as a strategy to increase efficiency: An analyses of interventional coronary procedures

Ana Paula Beck da Silva Etges  1   2   3   4 , Luciane Nascimento Cruz  1   5 , Rosane Schlatter  1   6 , Jeruza Neyeloff  1   6 , Ricardo Bertoglio Cardoso  2   4   5 , Luciane Kopittke  7 , Altacilio Aparecido Nunes  8 , José Alburquerque Neto  9 , José Luiz Nogueira  10 , Renata Melo de Assis  9 , Joilma Silva Prazeres Tobias  9 , José Antonio Marin-Neto  8 , Leila Beltrami Moreira  6 , Carisi Anne Polanczyk  1   2   4   5   6   11
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Time-driven activity-based costing as a strategy to increase efficiency: An analyses of interventional coronary procedures

Ana Paula Beck da Silva Etges et al. Int J Health Plann Manage. 2022 Jan.

Abstract

Monitoring the costs is one of the key components underlying value-based health care. This study aimed to evaluate the cost-saving opportunities of interventional coronary procedures (ICPs). Data from 90 patients submitted to elective ICP were evaluated in five Brazilian hospitals. Time-driven activity-based costing, that guides the cost estimates using the time consumed and the capacity cost rates per resource as the data input, was used to assess costs and the time spent over the care pathway. Descriptive cost analyses were followed by a labour cost-saving estimate potentially achieved by the redesign of the ICP pathway. The mean cost per patient varied from $807 to $2639. The length of the procedure phase per patient was similar among the hospitals, while the post-procedure phase presented the highest variation in length. The highest direct cost saving opportunities are concentrated in the procedure phase. By comparing the benchmark service with the most expensive one, it was estimated that redesigning physician practices could decrease 51% of the procedure cost. This application is pioneered in Brazil and demonstrates how detailed cost information can contribute to driving health care management to value by identifying cost-saving opportunities.

Keywords: TDABC; hospital management; interventional coronary procedure costs; microcosting; time-driven activity-based costing; value-based healthcare.

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References

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