Activity-Based Costing of Services in a Cardiac Center, Lamphun Hospital

Abstract

          The activity-based cost of services is essential data for accurate pricing decisions. This descriptive study aimed to analyze the activity-based cost of services, to compare the cost of services with the fees of service units under the Ministry of Public Health, and to analyze the break-even point for non-invasive cardiology laboratory services in a cardiac center in Lamphun Province. The framework for activity-based costing, developed by Kaplan and Cooper, consists of four steps: 1) develop the activity dictionary; 2) determine cost drivers for each activity; 3) identify the organization’s services and customers; and 4) select activity cost drivers that link activity costs to the organization’s services and customers. The sample consisted of five personnel and the service activities data in the cardiac center. The tools used in the study included the activity dictionary, the time-spent record form, and the cost record form which were tested for objectivity by three experts. The interrater reliability of the two observers was 1.0. The cost data were analyzed using descriptive statistics.
           The results revealed that:
           1. The activity-based cost of transthoracic echocardiography was 862.48 baht; the exercise stress test was 4,101.10 baht; the 24-hour Holter monitor electrocardiography was 704.23 baht; and the 48-hour Holter monitor electrocardiography was 718.73 baht.
           2. The activity-based cost of the exercise stress test was higher than fees of service units under the Ministry of Public Health while the activity-based costs of transthoracic echocardiography and 24 and 48-hour Holter monitor electrocardiography were lower than the fees of service units under the Ministry of Public Health.
          3. The break-even point of transthoracic echocardiography was 1,071 times per year; the exercise stress test was 230 times per year; the 24-hour Holter monitor electrocardiography was 64 times per year; and the 48-hour Holter monitor electrocardiography was 65 times per year.
           The hospital director and nurse administrators can use the data on activity-based costs to plan and manage resources effectively. In addition, a break-even point is important for planning service arrangements to be worthwhile and cost-effective while maintaining service quality in the cardiac center at Lamphun Hospital.