Exploring cost changes with time-driven activity-based costing after service delivery redesign in Dutch maternity care.

IF 1.6 Q3 HEALTH POLICY & SERVICES
Maud van den Berg, Hilco van Elten, Julia Spaan, Arie Franx, Kees Ahaus
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引用次数: 0

Abstract

The implementation of Value-Based Healthcare (VBHC) has spread across international healthcare systems, aiming to improve decision-making by combining information about patient outcomes and costs of care. Time-Driven Activity-Based Costing (TDABC) is introduced as a pragmatic yet accurate method to calculate costs of care pathways. It is often applied to demonstrate value-improving opportunities, such as interventions aimed at service delivery redesign. It is imperative for healthcare managers to know whether these interventions yield the expected outcome of improving patient value, for which TDABC is also suitable. However, its application becomes more complex and labour intensive if the intervention extends beyond activity-level changes in existing care pathways, to the implementation of entirely new care pathways. The complexity arises from the potential influence of such interventions on the costs of related care pathways. To fully comprehend the impact of such interventions on organizational costs, it is important to include these factors in the cost calculation. Given the substantial effort required for this analysis, this may explain the limited number of prior TDABC studies with similar objectives. This methodological development paper addresses this gap by offering a pragmatic enrichment of the TDABC methodology. This enrichment is twofold. First, it provides guidance on calculating a change in costs without the need for a total cost calculation. Second, to secure granularity, a more detailed level of cost-allocation is proposed. The aim is to encourage further application of TDABC to conduct financial evaluations of promising interventions in the domain of VBHC and service delivery redesign.

探索荷兰孕产妇护理服务重新设计后以时间驱动的活动成本计算的成本变化。
基于价值的医疗保健(Value-Based Healthcare,VBHC)的实施已在国际医疗保健系统中得到推广,其目的是通过结合患者疗效和医疗成本的信息来改进决策。时间驱动活动成本法(TDABC)作为一种实用而准确的方法被引入,用于计算医疗路径的成本。它通常用于展示提高价值的机会,如旨在重新设计服务提供的干预措施。医疗管理人员必须了解这些干预措施是否能产生提高患者价值的预期结果,TDABC 也适用于此。然而,如果干预措施超出了对现有护理路径进行活动层面的改变,而是要实施全新的护理路径,那么 TDABC 的应用就会变得更加复杂,劳动强度也更大。这种复杂性源于此类干预措施对相关护理路径成本的潜在影响。为了充分了解此类干预措施对组织成本的影响,必须将这些因素纳入成本计算。鉴于这一分析需要大量的工作,这可能是之前具有类似目标的 TDABC 研究数量有限的原因。这篇方法论发展论文通过对 TDABC 方法进行务实的充实,弥补了这一不足。这种充实包括两个方面。首先,它为计算成本变化提供了指导,而无需计算总成本。其次,为确保精细化,提出了更详细的成本分配。这样做的目的是鼓励进一步应用 TDABC,对自愿生物保健和服务提供重新设计领域有前途的干预措施进行财务评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health Services Management Research
Health Services Management Research HEALTH POLICY & SERVICES-
CiteScore
4.00
自引率
4.80%
发文量
33
期刊介绍: Health Services Management Research (HSMR) is an authoritative international peer-reviewed journal which publishes theoretically and empirically rigorous research on questions of enduring interest to health-care organizations and systems throughout the world. Examining the real issues confronting health services management, it provides an independent view and cutting edge evidence-based research to guide policy-making and management decision-making. HSMR aims to be a forum serving an international community of academics and researchers on the one hand and healthcare managers, executives, policymakers and clinicians and all health professionals on the other. HSMR wants to make a substantial contribution to both research and managerial practice, with particular emphasis placed on publishing studies which offer actionable findings and on promoting knowledge mobilisation toward theoretical advances.
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