Costing and performance in healthcare management

This chapter describes and discusses the methods for cost analysis of healthcare services in order to assess and compare the economic value of health outputs at the level of healthcare organizations. The economic principles underpinning the assessment of the value of healthcare services – opportunity costs and shadow prices – are presented together with the management accounting approach to cost services. The key features of micro-costing and gross-costing are also discussed and their relevance explained according to the investigators’ goals. The full costing is argued as the cost classification that better suits economic requirements for assessing the value of healthcare services. The technical phases that need to be taken to calculate full costs are also illustrated. It also discusses how costs and tariffs can be used to assess profitability of services delivery and benchmarking analysis across providers. The discussion of a case vignette helps in clarifying the use of costs and tariffs by decision-makers when actually applied to hospital services. Finally, it provides general conclusions and final recommendations on how management accounting principles can help translate economic paradigms in assessing and comparing the value of public productions in the healthcare sector for the decision-making process.