A time-driven activity-based costing model to improve health-care resource use in Mirebalais, Haiti

Mandigo, Morgan; O’Neill, Kathleen; Mistry, Bipin; Mundy, Bryan; Millien, Christophe; Nazaire, Yolande; Damuse, Ruth; Pierre, Claire; Mugunga, Jean Claude; Gillies, Robyn M.; Lucien, Franciscka; Bertrand, Karla Z.; Luo, Eva; Costas, Ainhoa; Greenberg, Sarah L M; Meara, John G.; Kaplan, Robert S.

doi:10.1016/s0140-6736(15)60817-0

Cited by 24 publications

(14 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An extension of this work might examine high-volume, high-cost inpatient services at the larger facilities as done in a previous Partners In Health project in Haiti. 32 Lastly, patient-level costs were not connected to patient-level outcomes. While this is a challenge even in high-income settings, longitudinal tracking of patients would have provided insights into the ways in which variations in services, and costs, were associated with outcomes.…”

Section: Discussionmentioning

confidence: 99%

Activity-based costing of health-care delivery, Haiti

McBain

Jérôme²,

Léandre³

et al. 2017

Bull. World Health Organ.

Self Cite

View full text Add to dashboard Cite

ObjectiveTo evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti.MethodsTogether with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient’s medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators.FindingsBetween March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit.ConclusionTime-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated.

show abstract

Section: Discussionmentioning

confidence: 99%

Activity-based costing of health-care delivery, Haiti

McBain

Jérôme²,

Léandre³

et al. 2017

Bull. World Health Organ.

Self Cite

View full text Add to dashboard Cite

show abstract

“…TDABC estimates the costs and time required for all activities and provides valuable information for process improvement and also cost containment. [15,22] Cost drivers are important, because they reveal the scope for improvement. This model can be updated easily and if any changes in capacity or costs may be adjusted to calculate a new capacity cost rate.…”

Section: Discussionmentioning

confidence: 99%

Applying Time Driven Activity-Based Costing to Calculate Cost of Computed Tomography Scan in a Teaching Hospital

C¹

2017

jemds

View full text Add to dashboard Cite

BACKGROUNDEscalating healthcare cost is a challenge in public health sector for financial manager. Choosing an appropriate accounting method is necessary for cost containment. In present study, we applied the time driven activity-based costing method to assess the cost in performing a computed tomography in a teaching hospital.The objectives of this study are: 1) To describe the application of Time Driven Activity-Based Costing (TDABC) to Computed Tomography (CT) scanning unit; 2) To obtain the cost of unused capacity of personnel and idle time cost of CT scanner; and 3) To appraise the evidence of benefits of such tools in health sector and its efficiency.

show abstract

“…27 While there are different approaches to costaccounting, 26 we applied time-driven activity-based costing (TD-ABC) [28][29][30][31][32][33] to measure the costs of performing CT of the abdomen/pelvis. The analysis combines traditional process maps with a financial cost accounting system, where every process required to complete imaging services is mapped, 28,31,[33][34][35] and the sum of all the costs of each step is the total cost of the procedure or imaging service. For abdomen/pelvis CT imaging, we found personnel costs comprised 80% of all direct costs, the highest being the cost related to the radiologist.…”

Section: Measuring Imaging Costsmentioning

confidence: 99%

Enhancing Value of MRI: A Call for Action

Anzai

Minoshima

Lee

2018

Magnetic Resonance Imaging

View full text Add to dashboard Cite

As national healthcare spending has spiraled out of control, payment reform that moves from volume to value‐based payment has been introduced as a practical solution. Under alternative value‐based payment models, physicians and clinical teams must deliver the best care possible at a lower cost. Medical imaging has changed the way we diagnose disease, evaluate severity, assess treatment effects, and provide biological insights for the pathophysiology of many diseases. Over the past 50 years, imaging techniques have become increasingly advanced—from X‐ray to computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and multi‐modal imaging. Advanced imaging such as MRI has given clinicians remarkable insights into medical conditions and saved innumerable lives. Under the value proposition, however, we must ask if each imaging study changes treatment decisions, improves patient outcomes, and is cost‐effective. Imaging research has been focused on developing new technologies and clinical applications to assess diagnostic accuracy. What is needed is the higher‐level technology assessment. In this article we review why we need to demonstrate the value of MRI, how we define value, what strategies can enhance MR value through partnership with various stakeholders, and how imaging scientists can contribute to healthcare delivery in the future. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:e40–e48.

show abstract

A time-driven activity-based costing model to improve health-care resource use in Mirebalais, Haiti

Cited by 24 publications

References 0 publications

Activity-based costing of health-care delivery, Haiti

Activity-based costing of health-care delivery, Haiti

Applying Time Driven Activity-Based Costing to Calculate Cost of Computed Tomography Scan in a Teaching Hospital

Enhancing Value of MRI: A Call for Action

Contact Info

Product

Resources

About