title: Time-Driven Activity-Based Costing in Emergency Medicine.
abstract: Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: byun@partners.org.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Yun
authors.affiliation: Division of Cardiovascular Imaging and Division of Emergency Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors.forename: Anand M
authors.initials: AM
authors.lastname: Prabhakar
authors.affiliation: Harvard Business School, Cambridge, MA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Warsh
authors.affiliation: Harvard Business School, Cambridge, MA.
authors.forename: Robert
authors.initials: R
authors.lastname: Kaplan
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: John
authors.initials: J
authors.lastname: Brennan
authors.affiliation: Harvard Business School, Cambridge, MA; Harvard Medical School, Boston, MA.
authors.forename: Kyle E
authors.initials: KE
authors.lastname: Dempsey
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors.forename: Ali S
authors.initials: AS
authors.lastname: Raja
mesh_terms: D004636:Emergency Service, Hospital / Q000191:economics* / Q000458:organization & administration; D005377:Financial Management, Hospital / Q000379:methods*; D006801:Humans; D013996:Time and Motion Studies; D014481:United States; D016526:Workload