[Activity-based cost model applied to tracer cardiovascular diseases].
OBJECTIVE
To analyze the costs of outpatient care on tracer ischemic cardiovascular diseases events in public healthcare institutions.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Dirección de Economía de la Salud, Programa de Prevención del Infarto en Argentina (Propia), Universidad Nacional de la Plata/Comisión de Investigaciones Cientificas de Buenos Aires, Argentina. sam@frlp.utn.edu.ar
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Marteau
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Perego
D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D001118:Argentina; D002318:Cardiovascular Diseases / Q000191:economics*; D003363:Cost Control; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000191:economics; D005102:Health Expenditures; D006300:Health Services Misuse / Q000191:economics; D006801:Humans; D006949:Hyperlipidemias / Q000191:economics; D006973:Hypertension / Q000191:economics; D010044:Outpatient Clinics, Hospital / Q000191:economics* / Q000706:statistics & numerical data