title: Extending simulation modeling to activity-based costing for clinical procedures.
abstract: A simulation model was developed to measure costs in an Emergency Department setting for patients presenting with possible cervical-spine injury who needed radiological imaging. Simulation, a tool widely used to account for process variability but typically focused on utilization and throughput analysis, is being introduced here as a realistic means to perform an activity-based-costing (ABC) analysis, because traditional ABC methods have difficulty coping with process variation in healthcare. Though the study model has a very specific application, it can be generalized to other settings simply by changing the input parameters. In essence, simulation was found to be an accurate and viable means to conduct an ABC analysis; in fact, the output provides more complete information than could be achieved through other conventional analyses, which gives management more leverage with which to negotiate contractual reimbursements.
authors.affiliation: Department of Management Services, University of North Carolina Health Care System, Chapel Hill 27514, USA.
authors.forename: N D
authors.initials: ND
authors.lastname: Glick
authors.forename: C C
authors.initials: CC
authors.lastname: Blackmore
authors.forename: W N
authors.initials: WN
authors.lastname: Zelman
mesh_terms: D000066:Accounting / Q000379:methods*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D003361:Cost Allocation / Q000379:methods*; D004180:Direct Service Costs / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D017059:Models, Econometric; D009657:North Carolina; D009874:Operations Research; D011859:Radiography; D011872:Radiology Department, Hospital / Q000191:economics*; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D013997:Time Factors