A New Scenario-Based Simulation Model for Cost Management of Healthcare Services through Improving the Efficiency of the Health Centers

Abstract

There is a need for an appropriate decision-making approach and a precise costing method in order to make appropriate decisions that result in managing the resource utilization, improving the efficiency of healthcare systems and processes, increasing the patient consent, and reducing the costs of healthcare services. Therefore, this study is to develop a new method for estimating and reducing the services’ costs by assessing the scenarios intended for the improvement of departments using time-driven activity-based costing (TDABC) and simulation model with conditions of uncertainty. To investigate the application of this method, the lithotripsy department of a kidney center has been studied and attempted to investigate the effects of different scenarios of scheduling the technicians’ presence and scheduling patients’ appointments, alongside the effects of controlling the factors of patient cancellation in different stages of the treatment process on lowering the healthcare costs and waiting time and on improving the hospital efficiency. The results showed that significant improvements in costs, waiting time, human resource utilization, and overall system efficiency were emerged. The impact of patient appointment scheduling scenarios on the abovementioned indexes was found to be far more than other scenarios. Furthermore, the results from the costs determined indicate a difference of 0.60, 0.61, 0.67, 0.67, and 0.63 percent between these costs and the costs determined by the traditional approaches. Such differences among the costs determined by these two approaches mainly occur due to different methods of allocating indirect costs and existence of uncertainty in the costs and time of therapeutic activities.