Modelling the costs of pre-hospital transport service for victims of road accidents in TDABC

Abstract

The pre-hospital transport of victims of road accidents in Morocco by basic ambulances concerns the majority of the population of victims requiring urgent care. It also constitutes the common service that benefits the entire population of victims, in terms of pre-hospital care. The objective of this contribution is to develop a model for calculating the costs of pre-hospital transport of road accident victims using Time-Driven Activity-Based Costing (TDABC). This model could be effective in better understanding how consumption occurs and how resources are administered and distribut-ed within the pre-hospital care service portfolio. The qualitative research approach that we have adopted in the con-text of this study has enabled us to map and identify all the activities and tasks carried out in the process of pre-hospital transport of road accident victims. The model obtained is flexible enough to adapt to the various situations of pre-hospital transport of road accident victims by basic ambulances. The application of this model in the Moroccan context, delimited in a well-defined round trip (civil protection - accident site - hospital - civil protection) demonstrates that the said model is valid for cost calculation. The calculations made (217.47 MAD, 224.31 MAD, 225.45 MAD and 226.59 MAD) allow us to identify the possible cases of victims transported by basic ambulance. However, the TDABC, applied to the pre-hospital transport of road accident victims, has some limitations, in particular the estimation of time which is the main key to the allocation of the consumed resources. The results show that the TDABC promotes a better knowledge of all the processes related to the pre-hospital transport service. It allows making visible the value of the costs of the victims of road accidents in the selected patient population. Indeed, when the model is used in the set of routes (black points), decision makers are able to see, on the one hand, the variation of costs between similar pre-hospital transport services and different routes for the same transport services and, on the other hand, the value of the costs of each category of road accident victims' population.