Cost and reimbursement analysis of selected hospital diagnoses via activity-based costing

Accurately estimating the cost and reimbursement of individual patients and groups of diagnoses has featured in numerous research studies in recent decades. The ever increasing cost of healthcare services, in contrast with the limited resources available, means hospitals have to utilize more advanced management and economics tools in order to boost their efficiency. Detailed and accurate cost-related information could result in superior decision-making and better resource utilization. The accuracy of calculating costs depends on the costing method used, with traditional methods often giving rise to inaccurate cost allocation. The study presents analysis of the costs and reimbursements of selected DRGs and patients within three particular departments at a Czech regional hospital (ENT, Dermatology and Neonatology). The costs of the given samples of patients were calculated by a custom Activity-Based Costing (ABC) application, comprising a more appropriate approach than a traditional costing method. The ABC methodology applied enables more accurate cost estimation for individual patients and DRGs, also generating a variety of additional cost-related information which could potentially inform any decision-making process. The study discusses the differences between the cost and reimbursement of individual diagnosis groups and cost variances between distinct patients within the each diagnosis, along with the managerial implications of the information obtained.