Department of Administrative Sciences, Université du Québec en Outaouais, C.P. 1240, Succ. Hull , Gatineau, J8X 3X7, Canada.
Department of Accounting, Université du Québec en Outaouais, C.P. 1240, Succ. Hull, Gatineau, J8X 3X7, Canada.
BMC Health Serv Res. 2024 Oct 28;24(1):1294. doi: 10.1186/s12913-024-11829-9.
Time-driven activity-based costing (TDABC) and activity-based costing (ABC) are methods used in the healthcare sector to assess the costs of patient care pathways. These methods help identify opportunities for optimizing and reducing activity times without compromising the quality of care. TDABC is recommended in the Value-Based Healthcare (VBHC) model to assess the outcomes of care pathways in relation to their associated costs. By focusing on the creation of value for patients, TDABC helps identify the interventions and processes that provide the most value in terms of clinical outcomes and patient satisfaction. This enables healthcare organizations to make informed decisions on improvements that will maximize value for patients. The aim of the study is to evaluate the cost of the oncology thoracic surgery care pathway prior to and following the implementation of digital health solution.
We have chosen to use the TDABC and ABC methods to calculate the costs of care pathway for oncology patients undergoing thoracic surgery in two healthcare establishments prior to and following the implementation of a digital health solution. By using these methods, we were able to calculate the costs associated with each stage of the patients' care pathway. This has given us a clearer picture of the costs associated with each activity and a better understanding of the sources of expenditure.
The results show that implementing the digital health solution and applying the principles of the VBHC model have provided tangible benefits in terms of reviewing processes and the roles of the various players involved, eliminating unnecessary or non-value-added activities, automating administrative or repetitive tasks, and improving coordination between the two healthcare establishments and between healthcare professionals. These improvements have contributed to better patient care.
Given the success observed in this pilot project, decision-makers chose to persistently implement this digital health solution for specific care pathways over the long term. Additionally, there is a commitment to further enhance the platform to align closely with the needs and the expectations of healthcare professionals. This proactive approach aims to ensure optimal utilization of resources, ultimately providing the best care to patients.
时间驱动作业成本法（TDABC）和作业成本法（ABC）是医疗保健领域中用于评估患者护理路径成本的方法。这些方法有助于确定优化和减少活动时间的机会，同时不影响护理质量。TDABC 建议在基于价值的医疗保健（VBHC）模型中用于评估护理路径的结果与其相关成本的关系。通过关注为患者创造价值，TDABC 有助于确定在临床结果和患者满意度方面提供最大价值的干预措施和流程。这使医疗保健组织能够就将最大价值最大化给患者的改进做出明智的决策。本研究的目的是评估在实施数字健康解决方案前后，肿瘤胸外科护理路径的成本。
我们选择使用 TDABC 和 ABC 方法来计算在实施数字健康解决方案之前和之后，在两个医疗机构中接受胸外科手术的肿瘤患者的护理路径的成本。通过使用这些方法，我们能够计算出与患者护理路径的每个阶段相关的成本。这使我们更清楚地了解与每个活动相关的成本，并更好地了解支出的来源。
结果表明，实施数字健康解决方案并应用 VBHC 模型的原则在审查流程和涉及的各个角色方面提供了切实的好处，消除了不必要或非增值活动，自动化了行政或重复任务，并改善了两个医疗机构之间以及医疗保健专业人员之间的协调。这些改进有助于更好地护理患者。
鉴于该试点项目取得的成功，决策者选择长期坚持为特定护理路径实施这种数字健康解决方案。此外，还承诺进一步增强该平台，以紧密符合医疗保健专业人员的需求和期望。这种积极主动的方法旨在确保资源的最佳利用，最终为患者提供最佳护理。
