Counting the costs of accreditation in acute care: an activity-based costing approach.
OBJECTIVE
To assess the costs of hospital accreditation in Australia.


METHODS
Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review.


METHODS
Acute care hospitals accredited by the Australian Council for Health Care Standards.


METHODS
Six acute public hospitals across four States.


RESULTS
Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year.


CONCLUSIONS
This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes.
Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Maquarie University, Sydney, New South Wales, Australia.
Virginia
http://orcid.org/0000-0001-7915-0615
V
Mumford
Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Maquarie University, Sydney, New South Wales, Australia.
David
D
Greenfield
Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Maquarie University, Sydney, New South Wales, Australia.
Anne
A
Hogden
School of Public Health and Community Medicine, UNSW Medicine, UNSW, Sydney, New South Wales, Australia.
Kevin
K
Forde
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Johanna
J
Westbrook
Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Maquarie University, Sydney, New South Wales, Australia.
Jeffrey
J
Braithwaite
D000068:Accreditation / Q000191:economics*; D001315:Australia; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000592:standards*; D006296:Health Services / Q000191:economics / Q000592:standards*; D017721:Hospital Costs; D006779:Hospitals, Public / Q000191:economics / Q000592:standards*; D006801:Humans; D058996:Quality Improvement / Q000191:economics*; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires