Cao P, Toyabe S, Kurashima S, Okada M, Akazawa K
Department of Medical Informatics and Pharmaceutics, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan.
Methods Inf Med. 2006;45(4):462-9.
Activity-based costing (ABC) is widely used to precisely allocate indirect costs to medical services. In the ABC method, the indirect cost is divided among the medical services in proportion to the volume of "cost drivers", for example, labor hours and the number of hours of surgery. However, the workload of data collection of cost drivers can be time-consuming and a considerable burden if there are many cost drivers. The authors aim to develop a method for objectively reducing the cost drivers used in the ABC method.
In the ABC method, the cost driver is assigned for each activity. We assume that these activities and cost drivers are the best combination. Our method, that is cost driver reduction (CDR), can objectively select surrogates of the cost drivers for each activity in ABC from candidate cost drivers. Concretely, the total indirect cost of an activity is temporarily allocated to the medical services using each candidate of cost drivers. The difference between the costs calculated by each candidate and the proper cost driver used in ABC is calculated to evaluate the similarity by the evaluation function.
We estimated the cost of laboratory tests using our method and revealed that the number of cost drivers could be reduced from seven in the ABC to four. Similarly, the results of cost estimation obtained by our method were as accurate as those calculated using the ABC.
Our method provides two advantages compared to the ABC method: 1) it provides results that are as accurate as those of the ABC method, and 2) it is simpler to perform complicated estimation of hospital costs.
作业成本法（ABC）被广泛用于将间接成本精确分配至医疗服务。在ABC法中，间接成本按“成本动因”的数量比例在各项医疗服务间进行分摊，例如人工工时和手术时长。然而，如果成本动因众多，收集成本动因数据的工作量可能耗时且负担颇重。作者旨在开发一种客观减少ABC法中所用成本动因的方法。
在ABC法中，为每项活动分配成本动因。我们假定这些活动和成本动因是最佳组合。我们的方法，即成本动因削减（CDR），能够从候选成本动因中为ABC法中的每项活动客观地选出成本动因的替代项。具体而言，一项活动的总间接成本被临时用每个成本动因候选项分摊至各项医疗服务。计算每个候选项计算出的成本与ABC法中所用恰当成本动因之间的差异，通过评估函数来评估相似性。
我们用我们的方法估算了检验项目的成本，结果显示成本动因数量可从ABC法中的7个减至4个。同样，我们的方法得出的成本估算结果与用ABC法计算得出的结果一样准确。
与ABC法相比，我们的方法有两个优点：1）其结果与ABC法的结果一样准确，2）进行复杂的医院成本估算更简便。
