Clinical Process Analysis and Activity-Based Costing at a Heart Center

  • Authors:

  • Lisa Ridderstolpe;Andreas Johansson;Tommy Skau;Hans Rutberg;Hans Åhlfeldt

  • Affiliations:

  • Department of Biomedical Engineering/Medical Informatics, Linköping University, University Hospital, S-581 85 Linköping, Sweden. Department of Cardiovascular Surgery, Linköping Hear ...;Ensolution AB, TeknoCenter, Halmstad, Sweden;Department of Cardiovascular Surgery, Linköping Heart Center, University Hospital, Linköping, Sweden;Department of Cardiovascular Surgery, Linköping Heart Center, University Hospital, Linköping, Sweden;Department of Biomedical Engineering/Medical Informatics, Linköping University, University Hospital, S-581 85 Linköping, Sweden

  • Venue:
  • Journal of Medical Systems
  • Year:
  • 2002

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Abstract

Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR®) containing two interrelated parts, “ProcessGuide and CostControl,” was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.