Extending Simulation Modeling to Activity-Based Costing for Clinical Procedures

  • Authors:
  • Noah D. Glick;C. Craig Blackmore;William N. Zelman

  • Affiliations:
  • Department of Management Services, University of North Carolina Health Care System, Hedrick Bldg., Suite &num/2091, 211 Friday Center Dr., Chapel Hill, North Carolina 27514. Voice: 919-966-6850 Fa ...;Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27516/ Department of Radiology, University of Washington-Harborview Medical Center, 98104;Department of Health Policy and Administration, University of North Carolina at Chapel Hill, School of Public Health, Chapel Hill, North Carolina 27599

  • Venue:
  • Journal of Medical Systems
  • Year:
  • 2000

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Abstract

A simulation model was developed to measure costs in an Emergency Department setting for patients presenting with possible cervical-spine injury who needed radiological imaging. Simulation, a tool widely used to account for process variability but typically focused on utilization and throughput analysis, is being introduced here as a realistic means to perform an activity-based-costing (ABC) analysis, because traditional ABC methods have difficulty coping with process variation in healthcare. Though the study model has a very specific application, it can be generalized to other settings simply by changing the input parameters. In essence, simulation was found to be an accurate and viable means to conduct an ABC analysis; in fact, the output provides more complete information than could be achieved through other conventional analyses, which gives management more leverage with which to negotiate contractual reimbursements.