نوع مقاله : مقاله پژوهشی
نویسندگان
1 دانشجوی دکتری تخصصی، حسابداری، گروه حسابداری، دانشکده حسابداری اقتصادی، دانشگاه ملی تاجیکستان، دوشنبه، تاجیکستان
2 کارشناس ارشد، حسابداری، گروه حسابداری، دانشکده علوم انسانی، دانشگاه علم و هنر، یزد، ایران
3 استادیار، خون و سرطان کودکان، مرکز تحقیقات خون و سرطان، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران
4 استادیار، خون و سرطان کودکان، گروه آنکولوژی کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران
چکیده
مقدمه: درمان تومور Wilms به عنوان شایع‌ترین تومور بدخیم کلیه در سنین کودکی، بار اقتصادی بالایی بر جامعه تحمیل می‌کند. از این‌رو، هدف از انجام پژوهش حاضر، محاسبه بهای تمام شده فرایند درمان تومور Wilms کودکان با استفاده از مدل بهایابی بر مبنای فعالیت زمان‌گرا TDABC (Time-Driven Activity-based Costing) بود.روش بررسی: این مطالعه با روش ﺗﻮﺻﯿﻔﯽ به پیاده‌سازی مدل TDABC در فرایند درمان تمامی 10 بیمار مبتلا به تومور Wilms بیمارستان شهید صدوقی در سال 1395 پرداخت. ابتدا فرایند درمان و فعالیت‌های پیرامون آن از طریق مصاحبه‌‌های نیمه ساختار یافته شناسایی و سپس بهای تمام شده فرایند درمان محاسبه گردید.یافته‌ها: بهای تمام شده فرایند درمان معادل ۴۲۰۵۱۲۱۸۳ ریال بود که 4/50 درصد از این مقدار به حقوق و دستمزد پرسنل اختصاص یافت. هزینه هر دقیقه خدمت پزشک متخصص در بخش آنکولوژی به عنوان گران‌ترین رسته شغلی در فرایند، معادل ۵۴۴۰۱ ریال شناسایی گردید. همچنین، هزینه ظرفیت بدون استفاده هزینه‌های عمومی در فرایند درمان معادل ۱۲۷۱۴۱۰۹ ریال تخمین زده شد.نتیجه‌گیری: بهای تمام شده کارکنان، بخش زیادی از هزینه‌های درمان بیماران را تشکیل می‌دهد. بنابراین، به منظور افزایش بهره‌وری، ضرورت برنامه‌ریزی و مدیریت منابع انسانی بیش از پیش احساس می‌شود.
کلیدواژه‌ها
عنوان مقاله [English]
Calculating the Cost of the Treatment Process for Wilms’ Tumor in Shahid Sadoughi Hospital, Yazd City, Iran
نویسندگان [English]
- Mohammadreza Hajighasemi 1
- Mahdieh Azhdari 2
- Azam Hashemi 3
- Alireza Jenabzade 4
1 PhD Student, Accounting, Department of Accounting, School of Economic Accounting, Tajik National University, Dushanbe, Tajikistan
2 MSc, Accounting, Department of Accounting, School of Humanities, University of Science and Arts, Yazd, Iran
3 Assistant Professor, Hematology and Oncology Pediatric, Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4 Assistant Professor, Hematology and Oncology Pediatric, Department of Pediatric Oncology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
چکیده [English]
Introduction: Wilms’ tumor is the most prevalent malignant kidney tumor in childhood. Treatment of this tumor imposes a high economic burden on the individuals. This study endeavored to calculate the cost of the treatment process of pediatric Wilms’ tumor using a time-driven activity-based costing model (TDABC), to reduce the costs.Methods: This descriptive study was implemented using a TDABC costing model on the costs of treatment process in 10 patients with Wilms’ tumor selected from Shahid Sadoughi hospital of in Yazd City, Iran, in the academic year of 2016. First, the treatment process and activities were identified through observations, and semi-structured interviews. Then, the cost was calculated for treatment process.Results: The cost of treatment was 420.512.183 Iranian Rials (IRRs), 50.4 % of which was allocated to the staff salaries. The cost per minute of specialist physician services was 54.401 IRRs in oncology ward that it was identified the most expensive job category in treatment process. Besides, unused capacity cost of overhead was calculated in treatment process as 12.714.109 IRRs.Conclusion: Findings revealed that the staff salaries involved great part of the charges. Therefore, it is necessary to manage the costs and human resources charges to be able to increase the productivity.
کلیدواژه‌ها [English]
- Therapeutics
- Costs and Cost Analysis
- Wilms Tumor
- Time-Driven Activity-based Costing
- Ilg AM, Laviana AA, Kamrava M, Veruttipong D, Steinberg M, Park SJ, et al. Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer. Brachytherapy 2016; 15(6): 760-7.
- Kaplan RS, Anderson SR. Time-driven activity-based costing: a simpler and more powerful path to higher profits. Boston, MA: Harvard Business Review Press; 2007.
- Hassanabadi M, Najjarsarraf A. Comprehensive operational budgeting model (Diamond Model). Tehran, Iran: Center for Industrial Research and Education of Iran; 2007. [In Persian].
- Schutzer ME, Arthur DW, Anscher MS. Time-driven activity-based costing: A comparative cost analysis of whole-breast radiotherapy versus balloon-based brachytherapy in the management of early-stage breast cancer. J Oncol Pract 2016; 12(5): e584-e593.
- Khani A, Mehrani S, Ghane E. Applying time-driven activity-based costing in the icu ward of shariati hospital of isfahan province. Journal of Health Accounting 2013; 2(4): 40-57. [In Persian].
- Beriwal S, Chino J. Time-driven activity-based costing in oncology: A step in the right direction. Int J Radiat Oncol Biol Phys 2018; 100(1): 95-6.
- Bauer-Nilsen K, Hill C, Trifiletti DM, Libby B, Lash DH, Lain M, et al. Evaluation of delivery costs for external beam radiation therapy and brachytherapy for locally advanced cervical cancer using time-driven activity-based costing. Int J Radiat Oncol Biol Phys 2018; 100(1): 88-94.
- Nabelsi V, Plouffe V. Breast cancer treatment pathway improvement using time-driven activity-based costing. Int J Health Plann Manage 2019; 34(4): e1736-e1746.
- Yu YR, Abbas PI, Smith CM, Carberry KE, Ren H, Patel B, et al. Time-driven activity-based costing to identify opportunities for cost reduction in pediatric appendectomy. J Pediatr Surg 2016; 51(12): 1962-6.
- Khan RM, Albutt K, Qureshi MA, Ansari Z, Drevin G, Mukhopadhyay S, et al. Time-driven activity-based costing of total knee replacements in Karachi, Pakistan. BMJ Open 2019; 9(5): e025258.
- Pershad Y, Albadawi H, Naidu S, Knuttinen M, Kriegshauser J, Oklu R. Abstract No. 599 Time-driven activity-based costing in interventional radiology: a pilot study. J Vasc Interv Radiol 2018; 29(4): S249-S250.
- Zaheri M, Amini P, Meshkani Z. Comparing the cost of services provided by oncology ward using traditional costing and activity-based costing (A case study: Tohid Hospital of Kurdistan). Journal of Health Accounting 2018; 7(2): 67-81. [In Persian].
- Alamshah SM. Calculating the cost of services of the laboratory department of Alami Herandi Clinic (Isfahan Social Security Organization) using time-driven activity based costing and comparing it with the approved tariffs in 2015 (1394). Journal of Health Accounting 2017; 6(1): 88-110. [In Persian].
- Shaarbafchizade N, Jabbari A, Hashemian M. Comparing the costs of radiology and CT-scan services in two hospitals affiliated to Isfahan University of Medical Sciences with approved tariffs and studying resource capacity using Time- Driven Activity Based Costing (TDABC) Method. Hospital 2019; 18(2): 75-90. [In Persian].
- Rahiminezhad A, Bagherpour M, Erjaie A, Sepehri M. Developing the human resources costing method depending on time-driven activity (A case study: Bu-Ali Sina Hospital, The Emergency Ward, Tehran). Journal of Health Accounting 2014; 3(2): 63-76. [In Persian].
- Pizzo PA, Poplack DG. Principles and practice of pediatric oncology. 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2001.
- Nathan DG, Oski FA, Look AT, Ginsburg D. Nathan and Oski's Hematology of Infancy and Childhood ((2-Vol. Set). 6th ed. Philadelphia, PA: Saunders; 2003. p. 1910-4.
- Bruggeman W, Everaert P, Anderson S, Levant Y. Modeling logistics costs using time-driven ABC: A case in a distribution company [Working Paper]. Ghent, Belgium: Faculty of Economics and Business Administration, Ghent University; 2005.
- Ruhumuriza J, Odhiambo J, Riviello R, Lin Y, Nkurunziza T, Shrime M, et al. Assessing the cost of laparotomy at a rural district hospital in Rwanda using time-driven activity-based costing. BJS Open 2018; 2(1): 25-33.
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