ABC Estimation of Unit Costs for Emergency Department Services

Holmes, Richard; Schroeder, Richard.

doi:10.1097/00004479-199604000-00005

Cited by 4 publications

(3 citation statements)

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“…There is also concerning evidence that lower cost provision in the for-profit sector is likely to be related to factors such as low pay and poorer training and development for staff-factors that impact negatively on the quality of provision [10]. Consequently, there is now a growing number of local authorities in England that have established plans to open in-house residential homes to meet the needs of their adolescent population [40], a divergence from the previous impetus to close local authority children's homes that has been prevalent during most of the 21st century in GB.…”

Section: Costsmentioning

confidence: 99%

Charting the 21st Century Rise of For-Profit Residential Child Care

Sen,

Ulybina,

Holmes

2024

Youth

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This article explores the increasing prevalence of for-profit residential care, with a particular focus on Great Britain, while also drawing on the international evidence from the Global North. Comprising a critical review of the published evidence (both academic and grey literature), the article seeks to examine what might explain the rising prevalence of and the possible associated impacts of the increase in for-profit provision. The findings indicate that the rise of for profit-companies among residential child care providers appears to have occurred by default, rather than explicit policy design. Our analysis also highlights gaps in the knowledge base about the quality of care and whether better quality is associated with the type of provider. Furthermore, the relationships between provider, quality, cost and outcomes are unclear. There are inconsistencies in the evidence base, with different conclusions being reached. However, available evidence tends to suggest the increased prevalence of for-profit residential child care providers has had an overall negative, rather than positive, effect. The best case in favour of the continued use of for-profit residential care is currently a non-moral pragmatic one: that in countries with medium and high prevalence of the use of residential child care, it would be hard to sustain care systems if for-profit providers were to suddenly withdraw or be withdrawn.

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Section: Costsmentioning

confidence: 99%

Charting the 21st Century Rise of For-Profit Residential Child Care

Sen,

Ulybina,

Holmes

2024

Youth

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“…Similarly, other authors define cost objects clustering as groups whose services similar demands for ED functions (i.e. ambulatory patient groups, physicians' current procedural terminology groups) [10].…”

Section: Cost Objectsmentioning

confidence: 99%

Cost objects: How is your ED performing?

Fuentes-Caceres

Neriz

Núñez

et al. 2020

BMC Health Serv Res

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Background: The aim of this study is to a propose a standardized methodology to identify a list of cost objects that can be used by any ED to compute costs considering that the resulting data must facilitate unit management by improving the information available for decision-making. Methods: This study considers two stages, first, we analyzed the case-mix of two hospitals collecting their data to define and diagram their processes, activities and to obtain their cost objects, second, we used four additional hospitals to validate our initial findings. Results: We recognized 59 cost objects. Hospitals may have all these cost objects or just a subset of them depending on the services they provide. Conclusions: Among the main benefits of our cost objects definition are: the possibility of tracing the processes generated by the services delivered by EDs, the economic sense in its grouping, the chance of using any costing methodology, the flexibility with other classification systems such as DRGs and ICDs, and the opportunity of costing for both diseases and treatments. Furthermore, cost comparison among hospitals using our final 59 cost objects list is more accurate and based on comparable units. In different EDs, each cost object will be the result of a similar combination of activities performed. We also present the results of applying this cost objects list to a particular ED. A total of 53 out of 59 cost objects were identified for that particular unit within a calendar year.

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“…The temporary disruption of utilization patterns caused by El Nin Äo during the time period of the study, and the addition of two clinics shortly after the completion of the study, limited the applicability of the cost analysis to MaxSalud's evolving patterns of services and resource consumption. Repeating the study on a regular basisÐ6 months would be idealÐwould ensure that the results are immediately applicable and would allow comparisons in unit y See Holmes and Schroeder (1996) for examples of these types of studies.…”

Section: Implementing Abcðfeasibility and Requirementsmentioning

confidence: 99%

Application of activity‐based costing (ABC) for a Peruvian NGO healthcare provider

Waters

Abdallah

Santillán

2001

Health Planning & Management

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This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.

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ABC Estimation of Unit Costs for Emergency Department Services

Cited by 4 publications

References 0 publications

Charting the 21st Century Rise of For-Profit Residential Child Care

Charting the 21st Century Rise of For-Profit Residential Child Care

Cost objects: How is your ED performing?

Application of activity‐based costing (ABC) for a Peruvian NGO healthcare provider

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