Implementation and results of TDABC in arthroscopic surgery: case study in an Ecuadorian hospital

Background : Based on extensive literature on case studies using the Time-Driven Activity-Based Costing (TDABC) system. The TDABC is accuracy in cost calculation is achieved through the availability of records on resource use, the estimation of a patient's resource consumption time, and the estimation of the time spent on activities by the healthcare professionals involved from the beginning to the end of each episode of patient care. A case study was conducted at a private university hospital in Ecuador. In this study, TDABC was applied to arthroscopic surgical procedures. Methods : The research used both qualitative and quantitative methods. The study examined economic information from 60 medical records of patients who had arthroscopic surgery at the hospital in the second half of 2022. Furthermore, the approach was prospective and retrospective in the information gathering process. Seven phases of cost determination in the healthcare sector were developed. The design of the process maps made it possible to identify in detail the time of resource consumption of the activities carried out during the complete care cycle of each patient undergoing this surgery. Results: Cost estimation was performed separately between direct and indirect costs, and it was found that treating costs using TDABC can reflect the real cost absorption of the arthroscopy service and that, despite having been a pilot study, it generates important information for managerial decision-making. Conclusions : It has been verified that determining costs under TDABC generates total costs higher than 50% for the arthroscopic surgery operations studied compared to the hospital's traditional costing system, which seems to indicate that it has considered all the costs related to them. JEL Classifications: M Business administration and Business Economics, Marleting, Accounting, Personal Economics. M4 Accounting and Auditing M41 Accounting.