Cost Accounting Methods In Healthcare

Healthcare expenditure is increasing worldwide with uncertainties regarding the effectiveness of the cost structure of the healthcare sector. Cost accounting is of significance in tracking, managing, and controlling costs, as well as evaluating their effectiveness, eliminating wastage, and the primary tool to this end are the costing methods applied by healthcare organisations. Due to the complexity and heterogeneity of medical services, specific accounting methods for an accurate assessment of costs are necessary. This paper aims to describe the particularities of medical services which make costing complex, as well as to identify the applicable methodologies described in the literature for costing in hospitals and medical practices. Traditional and innovative methods are explained and contrasted, with strengths and weaknesses highlighted for both. General costing methodologies and healthcare-specific ones like micro-costing and top-down costing are described. An emphasis is placed on time-driven activity-based costing (TDABC) and its potential to help alleviate some of the difficulties associated with cost management in the sector. A review of Bulgarian literature is attempted, to determine the applicable costing methodologies in the Bulgarian setting.