Cost of outpatient endoscopic sinus surgery from the perspective of the Canadian government: a time-driven activity-based costing approach
Cost of outpatient endoscopic sinus surgery from the perspective of the Canadian government: a time-driven activity-based costing approach
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DOI：
10.1002/alr.21181
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发表时间：
2013-09-01
影响因子：
6.4
通讯作者：
Rudmik, Luke
中科院分区：
文献类型：
--
作者：
Au, Jennifer;Rudmik, Luke
背景时间驱动的基于活动的成本计算（TD-ABC）方法是一种量化复杂系统成本的新颖方法。本研究的目的是应用TD-ABC技术从加拿大政府付款人的角度来定义常规门诊内窥镜鼻窦手术（ESS）的总体费用。方法成本核算的角度是加拿大政府付款人。截至 2012 年 12 月，所有货币价值均以加元为单位。费用是通过联系员工工会、审查采购数据库和省级医生费用表获得的。实际能力时间值是从艾伯塔省注册护士学院和协会收集的。计算所有员工、资本设备和医院空间的容量成本率（美元/分钟）。结果常规门诊 ESS 的总成本为 3510.31 美元。每次临床路径遭遇的每个 ESS 病例的费用如下：术前保留（49.19 美元）；术中（3296.60 美元）；消毒（90.20 美元）；麻醉后护理室（28.64 美元）；和术后日间病房（45.68 美元）。三个主要成本驱动因素是医生费用、一次性设备和护理费用。术中阶段占总费用的94.5%。结论本研究应用TD-ABC方法从加拿大政府付款人的角度评估门诊ESS的费用，并将总费用定义为每例3510.31美元。
BackgroundThe time-driven activity-based costing (TD-ABC) method is a novel approach to quantify the costs of a complex system. The aim of this study was to apply the TD-ABC technique to define the overall cost of a routine outpatient endoscopic sinus surgery (ESS) from the perspective of the Canadian government payer.MethodsCosting perspective was the Canadian government payer. All monetary values are in Canadian dollars as of December 2012. Costs were obtained by contacting staff unions, reviewing purchasing databases and provincial physician fee schedules. Practical capacity time values were collected from the College and Association of Registered Nurses of Alberta. Capacity cost rates ($/min) were calculated for all staff, capital equipment, and hospital space.ResultsThe overall cost for routine outpatient ESS was $3510.31. The cost per ESS case for each clinical pathway encounter was as follows: preoperative holding ($49.19); intraoperative ($3296.60); sterilization ($90.20); postanesthesia care unit ($28.64); and postoperative day ward ($45.68). The 3 major cost drivers were physician fees, disposable equipment, and nursing costs. The intraoperative phase contributed to 94.5% of the overall cost.ConclusionThis study applied the TD-ABC method to evaluate the cost of outpatient ESS from the perspective of the Canadian government payer and defined the overall cost to be $3510.31 per case.