Activity-based Costing of Common Caries Treatments Among Paediatric Patients

Abstract

Background: Activity-based costing (ABC) is a micro-costing method. Despite being an accurate tool for cost calculation, ABC system is rarely applied in the dental fraternity as it is complex to be conducted. Data gathered through ABC is beneficial in bridging the gap between policy makers who emphasise on cost saving and the practitioners who emphasise on quality of treatment. Aim: To conduct an ABC of common treatments for caries management among paediatric patients at Hospital Canselor Tuanku Muhriz (HCTM), Malaysia. Methods: ABC was conducted through a clinical pathway to lay out the routine activities of dental caries management among paediatric patients, and to gather information about the equipment, instruments and consumables used, personnel involved, and the time spent for each procedure. Then, these resources were assigned into different categories namely equipment more than RM 500.00, instruments less than RM 500.00, consumables and staff salary. Finally, cost drivers were determined by calculating the amount of resources used and the time spent. Results: Based on the clinical pathway conducted, there were 10 common treatments for caries management for paediatric patients. The common treatments involved were fissure sealant, glass ionomer cement (GIC) restoration for primary teeth, composite resin (CR) restoration for primary teeth, CR restoration for permanent teeth, strip crown restoration, stainless steel crown (SSC) restoration, pulpotomy, pulpectomy, extraction and scaling. The price range of treatment ranged from RM 60.00 to RM 450.00. Pulpotomy had the highest cost, whereas extraction of teeth had the lowest cost. Conclusion: Study on costing is important to reduce the gap between the demand in dental treatment and the limited resources available to perform the treatment. ABC is deemed to be appropriate to be used in this study as dental treatments are largely procedure-based and this costing method produces a a more precise and transparent data. The outcome of this data provides a tool for other hospitals to be used as a standardised approach for treating these patients and subsequently improve the quality of dental care given.