Application of activity-based costing (ABC) in the evaluation of eye-LASIK surgical cost in Taiwan.

摘要

The surgery fee is an often-debated topic in Taiwan's health service system. Especially in some procedures that patients have to pay out of their pockets like LASIK. This study evaluates eye-LASIK surgery costs and tries to find a method to establish an appropriate eye-LASIK surgery fee for hospitals.; Unlike the US health care system, health services reimbursement in Taiwan's health care system follows the Japanese tradition. Health care charges are included in the physician fee. Therefore, it is hard to distinguish the MD's contribution from the contribution of others. In this study, the physician fee will be separated and evaluated from the cost structure accurately by using the Activity-Based Costing Method and by Traditional Costing Method.; Two different costing systems, Activity-Based Costing and the Traditional Costing method were used, to compute each component cost of the 181 cases. Then they were analyzed using a paired t-test. A low p value for the test (less than 0.05) indicates that there is a significant difference between the two variables.; The total cost's mean of the 181 cases computed using Activity-Based Costing is NT{dollar}47,900.58 and the standard deviation is 265.40. The mean computed using the traditional costing is NT{dollar}42,871.81 and standard deviation is 8,985.83. There are no missing cases. The reason that a high SD showed is because that the total costs calculated using traditional method are not steady. Some component costs like supporting material cost and overhead cost could be misestimated in a particular month. The statistical outcome of samples calculated using Activity-Based Costing presents that 95% confidence interval for the mean is from 47861.65 at the lower bound to 47939.51 at the upper bound. The standard error is 19.72.; The results of the paired t-test show that t value is 7.365. The 95% confidence interval of the difference, from 3681.479 to 6376.068, does not include zero. And the p = 0.000 (less than 0.05) indicates that there is a significant difference between these two groups.; These findings can be hospitals' cost evaluation references and help to improve health care quality in Taiwan.