مقایسه بهای تمام‌شده خدمات ارائه شده به وسیله بخش آنکولوژی به روش‌های هزینه‌یابی سنتی و هزینه‌یابی بر مبنای فعالیت (مطالعه موردی: بیمارستان توحید استان کردستان)

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کارشناس ارشد حسابداری، واحد سنندج، دانشگاه آزاد اسلامی، کردستان، ایران.

2 استادیار، گروه حسابداری، دانشگاه کردستان، سنندج، ایران.

3 دانشجوی دکتری، مرکز تحقیقات مدیریت و اقتصاد سلامت، دانشکده مدیریت و اطلاع‌رسانی، دانشگاه علوم پزشکی ایران، تهران، ایران.

چکیده

مقدمه: با توجه به افزایش هزینه‌ها و محدودیت منابع، توجه به همه فعالیت‌ها و هزینه‌ها به منظور محاسبه بهای تمام‌شده خدمات ارائه شده به ویژه در بیمارستان‌ها ضروری است؛ زیرا شناسایی دقیق هزینه‌ها می‌تواند منجر به قیمت‌گذاری درست خدمات ارائه شده، شود.
روش پژوهش: پژوهش حاضر از نوع پژوهش‌های کاربردی و گذشته‌نگر بوده و شیوه گردآوری داده‌ها به روش بررسی اسناد و مدارک، مصاحبه با کارکنان واحد حسابداری و هم‌چنین مشاهده است. در این پژوهش هزینه‌ها بر اساس مبانی مربوط تسهیم شده و بهای تمام‌شده خدمات ارائه شده به وسیله بخش آنکولوژی بیمارستان توحید استان کردستان در سال 1393 به روش‌های هزینه‌یابی سنتی و هزینه‌یابی بر مبنای فعالیت محاسبه و با یکدیگر مقایسه شده است.
یافته‌ها: بهای تمام‌شده خدمات ارائه شده به وسیله بخش آنکولوژی بر اساس روش هزینه‌یابی سنتی حدود 29 میلیارد ریال و بر طبق روش هزینه‌یابی بر مبنای فعالیت، حدود 35 میلیارد ریال برآورد شد. هزینه‌های مستقیم و هزینه‌های غیرمستقیم، به ترتیب، 84% و 16% از کل هزینه‌ها را تشکیل می‌دهد و دارو و نیروی انسانی، به ترتیب، با 53% و 23% بیشترین میزان هزینه را نسبت به سایر سرفصل‌های هزینه‌ دارد.
نتیجه‌گیری: بهای تمام‌شده خدمات ارائه شده به وسیله بخش آنکولوژی بر اساس روش هزینه‌یابی بر مبنای فعالیت، حدود 6 میلیارد ریال از روش هزینه‌یابی سنتی بیشتر است. این موضوع نشان می‌دهد استفاده از روش هزینه‌یابی بر مبنای فعالیت اطلاعات واقعی‌تری را در مورد هزینه‌ها ارائه می‌کند. بنابراین، پیشنهاد می‌شود از روش هزینه‌یابی بر مبنای فعالیت در بیمارستان‌ها استفاده شود. هم‌چنین، نتایج پژوهش حاکی از آن است که مدیران به هزینه‌های غیرمستقیم به ویژه هزینه‌های سربار توجه نمی‌کنند. بنابراین، لازم است که این گروه از هزینه‌ها به درستی مدیریت شود.

کلیدواژه‌ها


عنوان مقاله [English]

Comparing the Cost of Services Provided by Oncology Ward Using Traditional Costing and Activity-Based Costing (A Case Study: Tohid Hospital of Kurdistan)

نویسندگان [English]

  • M. Zaheri 1
  • P. Amini 2
  • Z. Meshkani 3
1 M. A. in Accounting, Sanandaj Branch, Islamic Azad University, Kurdistan, Iran.
2 Assistant Professor, Department of Accounting, Kurdistan University, Sanandaj, Iran.
3 Ph. D. Student, Health Management and Economic Research Center, Faculty of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]

Introduction: Due to rising costs and resources constraints, it is required to consider all activities and costs for calculating the cost of services provided, particularly in hospitals. Since precise identification of costs can result in accurate pricing of provided services.
Method: It is an applied and retrospective study. Data was collected through document review, conducting and an interview with accounting department staff, and observation as well. In this study, costs are allocated according to the relevant bases and the costs of services provided by oncology ward of Tohid hospital of Kurdistan in 2014 are calculated through traditional costing and activity-based costing and then they are compared with each other.
Results: The costs of services provided by the oncology ward were estimated about 29 billion Rials using traditional costing and they were about 35 billion Rials using activity-based costing. Direct and indirect costs are accounted for 84% and 16% of total costs. And drug (53%) and manpower (23%) have the highest costs comparing to other cost headings.
Conclusion: The cost of services provided by the oncology ward using activity-based costing is nearly 6 billion Rilas higher than traditional costing that is activity-based costing presents more accurate information of costs. Thus, it is suggested to apply activity-based costing in hospitals. Also, the results indicate that managers do not consider indirect costs, especially overhead costs. Hence, these kinds of costs should be managed properly.

کلیدواژه‌ها [English]

  • Activity-Based Costing
  • Cost Analysis
  • Oncology
  • Traditional Costing
1        Arab, M.; Ghiasvand, H.; Darroudi, R.; Akbari Sari, A.; Hamidi, M.; and J. Moghri (2012). “Determining the Radiology Services Cost in Selected Hospitals Affiliated with Tehran University of Medical Sciences Using the Activity-Based Costing in 2010”, Journal of Hospital, Vol. 11, No. 3, pp. 27-36 . [In Persian]

2        Shoghli, A. and Y. Hamidi (2002). “Activity-Based Costing of Health Care Services at the Health Center”, Journal of Zanjan University of Medical Sciences, Vol. 10, No. 41, pp. 27-35. [In Persian]

3        Bjørnenak, T. (1997). “Diffusion and Accounting: The Case of ABC in Norway”, Management Accounting Research, Vol. 8, No. 1, pp. 3-17.

4        Cooper, R. and R. S. Kaplan (1991). “Profit Priorities from Activity-Based Costing”, Harvard Business Review, Vol. 63, No. 3, pp. 130-135.

5        Ebadi Fard Azar, F.; Gorji, A.; and R. Esmaeily (2006). “Calculating  and Analysing the Unit Cost of Services Provided in Shahid Sohrabali Bakhsi Health Care Center of Shahriyar Town  Using Activity-Based Costing”, Health Management Journal, Vol. 33, No. 9, pp. 31-40. [In Persian]

6        Bakhtiyari, P. (2017). Accounting and Financial Management for Managers, 20th Edition, Tehran: Industrial Management Publications. [In Persian]

7        Mohammadi, Y.; Baghestani, L.; Bahrami, M.; Entezarian Ardakani, S.; and Gh. Ahmadi Tehrani (2012). “Calculating the Cost of Dialysis Using Activity-Based Costing in Shahid Sadoughi Hospital of Yazd in 2011”, Journal of Health Accounting, Vol. 1, No. 1, pp. 73-84. [In Persian]

8        Siploof,  M. (2011). “Managing Cancer Treatment Begins Before Diagnosis”, Managed Care, Vol. 16, No. 3, pp. 8-26.

9        Bazyar, M.; Pourreza, A.; Harirchi, I.; Akbari, F.; and M. Mahmoudi (2012). “Investigating Medical and Non-Medical Direct Costs of Patients with Cancers Hospitalized in Imam Khomeini Cancer Institute of Tehran in 2010”, Journal of Hospital, Vol. 11, No. 1, pp. 39-50.  [In Persian]

10    Davari, M.; Moafi, A.; Yarmohammadian, M.; and E. Khayam Haghighi (2015). “The Medical Direct Costs of Acute Lymphocytic Leukemia (ALL) of Children in Isfahan Province”, Health Information Management, Vol. 11, No. 7, pp. 47-57.  [In Persian]

11    Khani, A.; Mehrani, S.; and E. Ghane  (2014). “Applying Time-Driven Activity-Based Costing in the ICU of Shariati Hospital of Isfahan Province”, Journal of Health Accounting, Vol. 2, No. 4, pp. 40-57 . [In Persian]

12    Kalman, N.; Hammill, B.; Schulman, K.; and B. Shah (2015). “Hospital Overhead Costs: The Neglected Driver of Health Care Spending? ”, Journal of Health Care Finance, Vol. 41, No. 4, pp. 1-12.

13    Dwivedi, R. and S. Chakraborty (2015). “Development of an Activity Based Costing Model for a Government Hospital”, Uncertain Supply Chain Management, Vol. 3, No. 1, pp. 27-42.

14    Cardos, I. R. and S. Pete (2011). “Activity-Based Costing (ABC) and Activity-Based Management (ABM) Implementation–Is This the Solution for Organizations to Gain Profitability?”, Romanian Journal of Economics, Vol. 32, No. 1, pp. 68-151.

15    Foster, G. and D. W. Swenson (1997). “Measuring the Success of Activity-Based Costing Management and its Determinants”, Journal of Management Accounting Research, Vol. 9, pp. 109-42.

16    Maiga, A. S. and F. A. Jacobs (2003). “Balanced Scorecard, Activity-Based Costing and Company Performance: An Empirical Analysis”, Journal of Managerial Issues, Vol. 15, No. 3, pp. 283-301.

17    Shander, A.; Hofmann, A.; Ozawa, S.; Theusinger, O. M.; Gombotz, H.; and D. R. Spahn (2010). “Activity‐Based Costing of Blood Transfusions in Surgical Patients at Four Hospitals”, Transfusion Journal, Vol. 50, No. 4, pp.753-65.

18    Odhiambo, J.; Ruhumuriza, J.; Nkurunziza, T.; Riviello, R.; Shrime, M.; Lin, Y.; Rusangwa, C.; Omondi, J. M.; Toma, G.; Nyirimodoka, A.; Mpunga, T; and B. L. Hedt-Gauthier (2019). “Health Facility Cost of Cesarean Delivery at a Rural District Hospital in Rwanda Using Time-Driven Activity-Based Costing”, Maternal and Child Health Journal, pp.1-10. Available at: https: //link.springer.com/article/10.1007%2Fs10995-018-2674-z. [Online][2 February 2019]

19    McBain, R. K.; Jerome, G.; Leandre, F.; Browning, M.; Warsh, J.; Shah, M.; and et al. (2018). “Activity-Based Costing of Health-Care Delivery, Haiti”, Bulletin of the World Health Organization, Vol. 96, No. 1, pp. 10-7.

20    Anzai, Y.; Heilbrun, M. E.; Haas, D.; Boi, L.; Moshre, K.; Minoshima, S.; Kaplan, R.; and V. S. Lee (2017). “Dissecting Costs of CT Study: Application of TDABC (Time-Driven Activity-Based Costing) in a Tertiary Academic Center”, Academic Radiology, Vol. 24, No. 2, pp. 200-208.

21    Jamie, R. and F. Rezaie Yamin (2015). “Calculating the Cost of Health Care Services in Isfahan Social Security Hospital Using Time-Driven Activity-Based Costing”, Journal of Health Accounting, Vol. 4, No. 2, pp. 1-21. [In Persian]

22    Beyranvand, R.; Ebadi Fard Azar, F.; Emamgholipour, S.; and M. Arab (2016). “Calculating the Cost of Physiotherapy Departmnet Services in Sina Hospital Affiliated to Tehran University of Medical Sciences Based on Activity-Based Costing and Comparing them with Tariffs Approved in 2013”,  Journal of Hospital, Vol. 15, No. 2, pp. 49-58. [In Persian] 

23    Bahadori, F.; Mahmoudi, G.; and M. Jahani (2016). “Determining the Cost of Cardiac Care Unit Services Using  Activity-Based Costing”, Journal of  North Khorasan  University of Medical Sciences, Vol. 8, No. 4, pp. 607-621. [In Persian]

24    Zamandi, M.; Zamandi, H.; Raei, B.; and A. Norouzi (2015). “Determining the Cost of Hematology Ward Services of Imam Reza Hospital Using
Activity-Based Costing in the First Semester of 2014”, Journal of Hospital, Vol. 4, No. 14, pp. 83-93. [In Persian]

25    Noori, M.; Markazi Moghaddam, N.; Goudarzi, R.; and Z. Meshkani (2016). “Investigating the Cost of Final Activity Centers (A Case Study: One of the Armed Forces Hospitals)”, Journal of Hospital, Vol. 15, No. 1, pp. 41-50. [In Persian]