[Activity-based cost model applied to tracer cardiovascular diseases]

To analyze the costs of outpatient care on tracer ischemic cardiovascular diseases events in public healthcare institutions.

The study was carried out from April to October 1998, on a sample of 2,000 (290 tracer diseases and 1,710 non-tracer diseases) first-time outpatient visits at the San Roque de Connet General Hospital, Buenos Aires, Argentina. Costs were evaluated using the Activity-Based Cost (ABC) method.

Outpatient care activity improvements would result in significant savings in indirect costs of 7.11% on average for products defined as high blood pressure, dyslipemia and diabetes. Total savings in unit cost per product from elimination of activities would be 11.78% for high blood pressure, 13.96% for dyslipemia, 19.05% for diabetes, and 11.45% for non-tracer diseases. A total of 66.26% of the total indirect costs corresponding to dyslipemia and 61.80% of the total indirect costs corresponding to diabetes were inefficiently allocated or misspent. The total unit cost of medical care assessed by the traditional method is $22.98, a figure that in some cases is quite below the cost obtained by the ABC method used in this study.

It is necessary to work on re-designing the patient healthcare process, to evaluate the activities which do not add any value, and that turn out to be a nuisance and delay for the patient. These activities make the system inefficient since resources are allocated to activities that hinder the process and that are therefore charged to the cost of medical visits.