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

Autor: da Silva Etges APB; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Rio Grande do Sul, Brazil.; Programa de Pós-graduação em Epidemiologia da Escola de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.; School of Technology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.; The TDABC in Healthcare Consortium, Porto Alegre, Rio Grande do Sul, Brazil., Cruz LN; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Rio Grande do Sul, Brazil.; Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil., Schlatter R; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Rio Grande do Sul, Brazil.; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil., Neyeloff J; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Rio Grande do Sul, Brazil.; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil., Cardoso RB; Programa de Pós-graduação em Epidemiologia da Escola de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.; The TDABC in Healthcare Consortium, Porto Alegre, Rio Grande do Sul, Brazil.; Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil., Kopittke L; Grupo Hospitalar Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil., Nunes AA; Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil., Neto JA; Hospital Universitário Presidente Dutra da Universidade Federal do Maranhão, São Luís, Maranhão, Brazil., Nogueira JL; Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., de Assis RM; Hospital Universitário Presidente Dutra da Universidade Federal do Maranhão, São Luís, Maranhão, Brazil., Tobias JSP; Hospital Universitário Presidente Dutra da Universidade Federal do Maranhão, São Luís, Maranhão, Brazil., Marin-Neto JA; Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil., Moreira LB; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil., Polanczyk CA; National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Rio Grande do Sul, Brazil.; Programa de Pós-graduação em Epidemiologia da Escola de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.; The TDABC in Healthcare Consortium, Porto Alegre, Rio Grande do Sul, Brazil.; Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.; Programa de Pós-graduação em Cardiologia da Escola de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Jazyk: angličtina
Zdroj: The International journal of health planning and management [Int J Health Plann Manage] 2022 Jan; Vol. 37 (1), pp. 189-201. Date of Electronic Publication: 2021 Sep 09.
DOI: 10.1002/hpm.3320
Abstrakt: 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.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje