Establishing an Activity-Based Costing and Management System for Management Decisions： An Example of Occupational Therapy and Case management units in Psychiatry Department in a Medical Center
Date Issued
2005
Date
2005
Author(s)
Shieh, Chia-lung
DOI
zh-TW
Abstract
In order to control the expenditures of the National Health Insurance, many policies to contain the supply and demand of health care have been in effect, and the reimbursement system was directed into an overall global budget mechanism in July 2002. Therefore, with the constraint on the growth of hospital’s revenues, cost management has become one of the most important issues facing hospital managers in Taiwan.
The traditional cost accounting system, widely used by domestic hospitals, is based on responsibility centers and can only calculate the cost of the department level. Due to lake of cause-effect relationships, it does not reasonably reflect the actual cost and cause cross subsidization among departments. It may thus end up leading to wrong decisions for the management. With ABC/M’s cause-effect basis, all costs and the relationships among products, activities and resources could be clearly developed; therefore, such information could serve as valuable reference in making decisions.
A psychiatry department serves different client groups and has various professionals. It is faced with increasing financial challenges and must be equipped with systems to evaluate the contributions of different professionals. Therefore, to construct a suitable cost management system for Psychiatry department is inevitable. However, due to the variety and variability consuming human resource and capital, either the traditional accounting system or standard costing system could not reflect the actual costs of services provided by a psychiatry department and is thus of limited assistance to hospital mangers.
Based on the ABC/M principles, the objective of this research is to establish a costing and management model for a psychiatry department of occupational therapy and case management units in a medical center. The data were collected for six months, from January to June, 2004. Results can be summarized as followed:
1. Occupational therapy and case management units provide eleven products and ten activities.
2. 45.6% of personal costs, 31.6% of costs are department overhead, 19.4% of costs are hospital overhead allocated, and 3.4% of costs are related to materials.
3. The group therapy is the largest activity costs (20.5%), followed by the recording activity (15.2%), and individual therapy (9.8%) in the occupational therapy unit.
4. The administration and preparation activity is the largest activity costs (19.2%), followed by the recording activity (14.5%), and group therapy (8.7%) in the case management unit.
5. The human workload is 83.4% of the occupational therapy unit and 49.2% of the case management unit.
The conclusion of this study as the following:
1. ABC/M can provide service-level cost and the assist the psychiatry department to conduct cost management.
2. ABC/M can help manager to capacity management and performance evaluation.
3. ABC/M can clearly delineate and assist cost control.
4. ABC/M could provide valuable information for managers for their decision-making reference.
Subjects
作業基礎成本管理
精神科
Activity-Based Costing and Management
Psychiatry Department
SDGs
Type
thesis
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