Time Driven Activity Based Costing (TDABC), cost calculation model adapted to chronic disease care pathway? Cases of stroke care pathway

Le Time Driven Activity Based Costing (TDABC), modèle de calcul de coût adapté au parcours de soins des maladies chroniques ?

Hugues Domingo (), Ariel Eggrickx (), Gérald Naro () and Rodolphe Bourret
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Hugues Domingo: MRM - Montpellier Research in Management - UPVM - Université Paul-Valéry - Montpellier 3 - UPVD - Université de Perpignan Via Domitia - Groupe Sup de Co Montpellier (GSCM) - Montpellier Business School - UM - Université de Montpellier
Ariel Eggrickx: MRM - Montpellier Research in Management - UPVM - Université Paul-Valéry - Montpellier 3 - UPVD - Université de Perpignan Via Domitia - Groupe Sup de Co Montpellier (GSCM) - Montpellier Business School - UM - Université de Montpellier
Gérald Naro: MRM - Montpellier Research in Management - UPVM - Université Paul-Valéry - Montpellier 3 - UPVD - Université de Perpignan Via Domitia - Groupe Sup de Co Montpellier (GSCM) - Montpellier Business School - UM - Université de Montpellier
Rodolphe Bourret: Centre hospitalier [Valenciennes, Nord]

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Abstract: Chronic diseases are the main item of health expenditure, they require a global and transversal support of the patient via the care pathway, while Diagnosis related groups based payment contributes to strengthening the divisions. An intervention research on a chronic disease pathway, the stroke, 3rd death cause in France, aims verifying the applicability of a cost-per-activity calculation such as Time Driven Activity Based Costing (TDABC). According to the criteria of simplicity and precision of cost evaluation methods, the literature suggests that a cost-per-activity calculation is adapted to the transversal approaches and to the health sector. The research findings limited to a part of the pathway show the applicability of the TDABC and the taking into account in the time equations of the costs variations linked to the pathways diversity and the treatment evolutions. Despite the method limitations (difficulty of estimating time and considering what is nonquantifiable as the cares value), the TDABC presents several contributions : possible simplification by the Pareto law, a tool that is understandable by health professionals and sparking dialogue, simulation of the « hidden costs » of resource unavailability and bottlenecks.

Keywords: TIME DRIVEN ACTIVITY BASED COSTING; Cost calculation; Hidden costs; Chronic disease; Healthcare pathway; calcul de coûts; coûts cachés; maladies chroniques; parcours de soins (search for similar items in EconPapers)
Date: 2018-10-22
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Published in Gestion et management public [2012-..], 2018, 6 (3), pp.71-93. ⟨10.3917/gmp.063.0071⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01988158

DOI: 10.3917/gmp.063.0071

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