Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department
Abstract Objectives The aim of this study was: (1) to adapt the time‐driven activity‐based costing (TDABC) method to emergency department (ED) ambulatory care; (2) to estimate the cost of care associated with frequently encountered ambulatory conditions; and (3) to compare costs calculated using est...
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12778 |
| _version_ | 1811183245413318656 |
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| author | Simon Berthelot Myriam Mallet Sébastien Blais Lynne Moore Jason R. Guertin Justine Boulet Christian Boilard Camille Fortier Benoît Huard Akram Mokhtari Annika Lesage Émilie Lévesque Laurence Baril Pascale Olivier Keven Vachon Olivia Yip Mathieu Bouchard David Simonyan Mélanie Létourneau Amélie Pineault Adrien Vézo Henry T. Stelfox |
| author_facet | Simon Berthelot Myriam Mallet Sébastien Blais Lynne Moore Jason R. Guertin Justine Boulet Christian Boilard Camille Fortier Benoît Huard Akram Mokhtari Annika Lesage Émilie Lévesque Laurence Baril Pascale Olivier Keven Vachon Olivia Yip Mathieu Bouchard David Simonyan Mélanie Létourneau Amélie Pineault Adrien Vézo Henry T. Stelfox |
| author_sort | Simon Berthelot |
| collection | DOAJ |
| description | Abstract Objectives The aim of this study was: (1) to adapt the time‐driven activity‐based costing (TDABC) method to emergency department (ED) ambulatory care; (2) to estimate the cost of care associated with frequently encountered ambulatory conditions; and (3) to compare costs calculated using estimated time and objectively measured time. Methods TDABC was applied to a retrospective cohort of patients with upper respiratory tract infections, urinary tract infections, unspecified abdominal pain, lower back pain and limb lacerations who visited an ED in Québec City (Canada) during fiscal year 2015–2016. The calculated cost of care was the product of the time required to complete each care procedure and the cost per minute of each human resource or equipment involved. Costing based on durations estimated by care professionals were compared to those based on objective measurements in the field. Results Overall, 220 care episodes were included and 3080 time measurements of 75 different processes were collected. Differences between costs calculated using estimated and measured times were statistically significant for all conditions except lower back pain and ranged from $4.30 to $55.20 (US) per episode. Differences were larger for conditions requiring more advanced procedures, such as imaging or the attention of ED professionals. Conclusions The greater the use of advanced procedures or the involvement of ED professionals in the care, the greater is the discrepancy between estimated‐time‐based and measured‐time‐based costing. TDABC should be applied using objective measurement of the time per procedure. |
| first_indexed | 2024-04-11T09:44:43Z |
| format | Article |
| id | doaj.art-dca85ddf137048789128399b5a7a4ee9 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-04-11T09:44:43Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-dca85ddf137048789128399b5a7a4ee92022-12-22T04:31:07ZengWileyJournal of the American College of Emergency Physicians Open2688-11522022-08-0134n/an/a10.1002/emp2.12778Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency departmentSimon Berthelot0Myriam Mallet1Sébastien Blais2Lynne Moore3Jason R. Guertin4Justine Boulet5Christian Boilard6Camille Fortier7Benoît Huard8Akram Mokhtari9Annika Lesage10Émilie Lévesque11Laurence Baril12Pascale Olivier13Keven Vachon14Olivia Yip15Mathieu Bouchard16David Simonyan17Mélanie Létourneau18Amélie Pineault19Adrien Vézo20Henry T. Stelfox21CHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaCHU de Québec‐Université Laval Québec CanadaDepartment of Critical Care and the O'Brien Institute for Public Health McCaig Tower University of Calgary Calgary Alberta CanadaAbstract Objectives The aim of this study was: (1) to adapt the time‐driven activity‐based costing (TDABC) method to emergency department (ED) ambulatory care; (2) to estimate the cost of care associated with frequently encountered ambulatory conditions; and (3) to compare costs calculated using estimated time and objectively measured time. Methods TDABC was applied to a retrospective cohort of patients with upper respiratory tract infections, urinary tract infections, unspecified abdominal pain, lower back pain and limb lacerations who visited an ED in Québec City (Canada) during fiscal year 2015–2016. The calculated cost of care was the product of the time required to complete each care procedure and the cost per minute of each human resource or equipment involved. Costing based on durations estimated by care professionals were compared to those based on objective measurements in the field. Results Overall, 220 care episodes were included and 3080 time measurements of 75 different processes were collected. Differences between costs calculated using estimated and measured times were statistically significant for all conditions except lower back pain and ranged from $4.30 to $55.20 (US) per episode. Differences were larger for conditions requiring more advanced procedures, such as imaging or the attention of ED professionals. Conclusions The greater the use of advanced procedures or the involvement of ED professionals in the care, the greater is the discrepancy between estimated‐time‐based and measured‐time‐based costing. TDABC should be applied using objective measurement of the time per procedure.https://doi.org/10.1002/emp2.12778emergency medicineemergency servicefinancial Managementhospital/methodshospital/organization & administrationTime‐driven activity‐based costing |
| spellingShingle | Simon Berthelot Myriam Mallet Sébastien Blais Lynne Moore Jason R. Guertin Justine Boulet Christian Boilard Camille Fortier Benoît Huard Akram Mokhtari Annika Lesage Émilie Lévesque Laurence Baril Pascale Olivier Keven Vachon Olivia Yip Mathieu Bouchard David Simonyan Mélanie Létourneau Amélie Pineault Adrien Vézo Henry T. Stelfox Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department Journal of the American College of Emergency Physicians Open emergency medicine emergency service financial Management hospital/methods hospital/organization & administration Time‐driven activity‐based costing |
| title | Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department |
| title_full | Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department |
| title_fullStr | Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department |
| title_full_unstemmed | Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department |
| title_short | Adaptation of time‐driven activity‐based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department |
| title_sort | adaptation of time driven activity based costing to the evaluation of the efficiency of ambulatory care provided in the emergency department |
| topic | emergency medicine emergency service financial Management hospital/methods hospital/organization & administration Time‐driven activity‐based costing |
| url | https://doi.org/10.1002/emp2.12778 |
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