Hospital cost accounting and analysis

Abstract

We describe a cost-accounting method developed in the department (state) of Valle del Cauca, Colombia, and analyze some results of an intensive study of six months' costs at the hospital-health center in Candelaria. Data on total and average costs of services in all programs are used to examine certain questions of efficiency, especially those showing possible gains from the substitution of paramedical personnel and medical students for staff physicians. Our data for specific programs indicate possible opportunities for cost savings with the substitution of personnel, although the lack of data on outcomes suggests caution in such an interpretation. We also demonstrate the importance of distinguishing between changes that occur in the volume of services used and those factors that affect total costs when analyzing average costs. The more inclusive methods we employed yielded values markedly different from those found by more conventional cost-accounting approaches. Both the general method used and the specific findings illustrate the desirability of extending this approach to other health care institutions to assist administrators and planners in decision making.