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Abstract
This research aims to determine the application of cost accounting (unit cost) through the Activity-Based Costing (ABC) method in establishing service rates at Regional Public Service Agency Hospitals (BLUD Hospital). Among the unit costs studied at the BLUD Hospital, the focus was on the surgical service unit. Despite its potential, the ABC method is still underutilized for calculating unit service costs in BLUD hospitals. The evaluation compared traditional tariff calculations, based on Minister of Finance Regulation No. 3 of 2023, with calculations derived from the ABC method. The study's findings revealed that activity-based surgical service units incur unit costs of Rp. 1,205,171.55 for special surgeries, Rp. 935,780.27 for major surgeries, and Rp. 510,425.60 and Rp. 283,569.78 for medium and small operations, respectively. These unit costs serve as the foundation for determining rates by adding the direct costs of each unit. In accordance, service rates will be generated. Notably, the determined tariffs in INA-CBGs are IDR 4,250,000 for special surgeries, IDR 3,300,000 for major surgeries, IDR 1,800,000 for medium surgeries, and IDR 1,000,000 for small surgeries. Consequently, this study recommends the BLUD Hospital management to adopt the ABC method in calculating unit costs as it revealed that the costs attributed to patients in the surgical service unit were lower than the traditional costing method.
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Copyright (c) 2025 Yunan Najamuddin , Dekar Urumsah, Mahmudi, Reni Yendrawati, Teduh Dirgahayu, Novi Dwi Rugiarti, Asri Dwi Ariyani, Avininda Dewi Nindiasari, Rosita
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References
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- Aldogan, M., Austill, A. D., & Kocakülâh, M. C. (2014). Journal of Health Care Finance www.HealthFinanceJournal.com. 13(July).
- Ali Habibi. (2012). Activity based costing model in laboratory of care hospital. African Journal of Business Management, 6(23), 6811–6817. https://doi.org/10.5897/ajbm11.405
- Asbu, E. Z., Masri, M. D., & Naboulsi, M. Al. (2020). Determinants of Hospital Efficiency: insights from the literature. International Journal of Healthcare, 6(2), 44-53. https://doi.org/10.21203/rs.2.15354/v2
- Bataineh, A. (2018). Applicability of activity-based costing in the Jordanian hospitality industry. International Journal of Economics and Business Research, 15(4), 475–489. https://doi.org/10.1504/IJEBR.2018.092153
- Datar, S. M., & Rajan, M. V. (2021). Horngren ’ s Cost Accounting A Managerial Emphasis (Seventeent).
- Demeere, N., Stouthuysen, K., & Roodhooft, F. (2009). Time-driven activity-based costing in an outpatient clinic environment: Development, relevance and managerial impact. Health Policy, 92(2–3), 296–304. https://doi.org/10.1016/j.healthpol.2009.05.003
- Doyle, G. (2014). An Empirical Study of Adoption / Non-adoption of Activity Based Costing in Hospitals in Ireland Gerardine Doyle , Lisa Duffy and Melissa McCahey UCD Business Schools. November.
- Fidanza, A., Schettini, I., Palozzi, G., Mitrousias, V., Logroscino, G., Romanini, E., & Calvisi, V. (2022). What Is the Inpatient Cost of Hip Replacement? A Time-Driven Activity Based Costing Pilot Study in an Italian Public Hospital. Journal of Clinical Medicine, 11(23). https://doi.org/10.3390/jcm11236928
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- Kalinowski, J. (2024). Cost Analysis of Medical Procedures : A Case Study on Interventional Radiology. European Research Studies Journal, XXVII(S2), 290–300.
- Kaplan, R. S., & Cooper, R. (1998). Cost and effect: Using integrated cost systems to drive profitability and performance. Harvard Business School Press.
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- Lievens, Y., Obyn, C., Mertens, A. S., Halewyck, D. Van, & Hulstaert, F. (2015). Stereotactic body radiotherapy for lung cancer: How much does it really cost? Journal of Thoracic Oncology, 10(3), 454–461. https://doi.org/10.1097/JTO.0000000000000421
- Lin, C., Wang, S., & Qiao, Z. (2013). Product Profitability Analysis Based on EVA and ABC. International Journal of Business and Management, 8(12), 73–82. https://doi.org/10.5539/ijbm.v8n12p73
- Neriz, L., Núñez, A., & Ramis, F. (2014). A cost management model for hospital food and nutrition in a public hospital. BMC Health Services Research, 14(1), 1–12. https://doi.org/10.1186/s12913-014-0542-0
- Öker, F., & Özyapc, H. (2013). A new costing model in hospital management: Time-driven activity-based costing system. Health Care Manager, 32(1), 23–36. https://doi.org/10.1097/HCM.0b013e31827ed898
- Rajabi, A. (2008). The role of activity based costing (ABC) system in governmental hospital services in Iran. Iranian Red Crescent Medical Journal, 10(2), 89–94.
- Rajabi, A., & Dabiri, A. (2012). Applying activity based costing (ABC) method to calculate cost price in hospital and remedy services. Iranian Journal of Public Health, 41(4), 100–107.
- Sanches, L. B., Junior, T. P., Bonizio, R. C., Piratelli, C. L., & Gaio, L. E. (2020). Activity Based Cost System Applied in Surgical Center of a Brazilian Large Hospital. FACEF Pesquisa - Desenvolvimento e Gestão, 23(3).
- West, T. D., & West, D. A. (1997). Applying ABC to Healthcare. Management Accounting, February, 22–33. http://dx.doi.org/10.1016/j.jaci.2012.05.050
- Yereli, A. N. (2009). Activity-Based Costing and Its Application in a Turkish University Hospital. AORN Journal, 89(3). https://doi.org/10.1016/j.aorn.2008.09.002
- Peraturan Menteri Kesehatan no 3 tahun 2023, “Tentang Standar Tarif Pelayanan Kesehatan Dalam Penyelenggaraan Program Jaminan Kesehatan”, Menteri Kesehatan Republik Indonesia.
References
Akhavan, S., Ward, L., & Bozic, K. J. (2016). Time-driven Activity-based Costing More Accurately Reflects Costs in Arthroplasty Surgery. Clinical Orthopaedics and Related Research, 474(1), 8–15. https://doi.org/10.1007/s11999-015-4214-0
Aldogan, M., Austill, A. D., & Kocakülâh, M. C. (2014). Journal of Health Care Finance www.HealthFinanceJournal.com. 13(July).
Ali Habibi. (2012). Activity based costing model in laboratory of care hospital. African Journal of Business Management, 6(23), 6811–6817. https://doi.org/10.5897/ajbm11.405
Asbu, E. Z., Masri, M. D., & Naboulsi, M. Al. (2020). Determinants of Hospital Efficiency: insights from the literature. International Journal of Healthcare, 6(2), 44-53. https://doi.org/10.21203/rs.2.15354/v2
Bataineh, A. (2018). Applicability of activity-based costing in the Jordanian hospitality industry. International Journal of Economics and Business Research, 15(4), 475–489. https://doi.org/10.1504/IJEBR.2018.092153
Datar, S. M., & Rajan, M. V. (2021). Horngren ’ s Cost Accounting A Managerial Emphasis (Seventeent).
Demeere, N., Stouthuysen, K., & Roodhooft, F. (2009). Time-driven activity-based costing in an outpatient clinic environment: Development, relevance and managerial impact. Health Policy, 92(2–3), 296–304. https://doi.org/10.1016/j.healthpol.2009.05.003
Doyle, G. (2014). An Empirical Study of Adoption / Non-adoption of Activity Based Costing in Hospitals in Ireland Gerardine Doyle , Lisa Duffy and Melissa McCahey UCD Business Schools. November.
Fidanza, A., Schettini, I., Palozzi, G., Mitrousias, V., Logroscino, G., Romanini, E., & Calvisi, V. (2022). What Is the Inpatient Cost of Hip Replacement? A Time-Driven Activity Based Costing Pilot Study in an Italian Public Hospital. Journal of Clinical Medicine, 11(23). https://doi.org/10.3390/jcm11236928
Ibrahim, R., Muhd Nur, A., S. A. Zafirah, & Aljunid, S. M. (2018). The Cost of Radiology Procedures Using Activity Based Costing (ABC) for Development of Cost Weights in Implementation of Casemix System in Malaysia. Jurnal Sains Kesihatan Malaysia, 16(01), 155–162. https://doi.org/10.17576/jskm-2018-1601-19
Javid, M., Hadian, M., Ghaderi, H., Ghaffari, S., & Salehi, M. (2016). Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital. Global Journal of Health Science, 8(1), 165–172. https://doi.org/10.5539/gjhs.v8n1p165
Kalinowski, J. (2024). Cost Analysis of Medical Procedures : A Case Study on Interventional Radiology. European Research Studies Journal, XXVII(S2), 290–300.
Kaplan, R. S., & Cooper, R. (1998). Cost and effect: Using integrated cost systems to drive profitability and performance. Harvard Business School Press.
Koolmees, D., Bernstein, D. N., & Makhni, E. C. (2021). Time-Driven Activity-Based Costing Provides a Lower and More Accurate Assessment of Costs in the Field of Orthopaedic Surgery Compared With Traditional Accounting Methods. Arthroscopy - Journal of Arthroscopic and Related Surgery, 37(5), 1620–1627. https://doi.org/10.1016/j.arthro.2020.11.028
Kuchta, D., & Sabina, Z. (2011). Activity-based costing for health care institutions. 8thInternational Conference on Enterprise Systems, Accounting and Logistics (8th ICESAL 2011) 11-12 July 2011, Thassos Island, Greece, July, 300–311.
Lievens, Y., Obyn, C., Mertens, A. S., Halewyck, D. Van, & Hulstaert, F. (2015). Stereotactic body radiotherapy for lung cancer: How much does it really cost? Journal of Thoracic Oncology, 10(3), 454–461. https://doi.org/10.1097/JTO.0000000000000421
Lin, C., Wang, S., & Qiao, Z. (2013). Product Profitability Analysis Based on EVA and ABC. International Journal of Business and Management, 8(12), 73–82. https://doi.org/10.5539/ijbm.v8n12p73
Neriz, L., Núñez, A., & Ramis, F. (2014). A cost management model for hospital food and nutrition in a public hospital. BMC Health Services Research, 14(1), 1–12. https://doi.org/10.1186/s12913-014-0542-0
Öker, F., & Özyapc, H. (2013). A new costing model in hospital management: Time-driven activity-based costing system. Health Care Manager, 32(1), 23–36. https://doi.org/10.1097/HCM.0b013e31827ed898
Rajabi, A. (2008). The role of activity based costing (ABC) system in governmental hospital services in Iran. Iranian Red Crescent Medical Journal, 10(2), 89–94.
Rajabi, A., & Dabiri, A. (2012). Applying activity based costing (ABC) method to calculate cost price in hospital and remedy services. Iranian Journal of Public Health, 41(4), 100–107.
Sanches, L. B., Junior, T. P., Bonizio, R. C., Piratelli, C. L., & Gaio, L. E. (2020). Activity Based Cost System Applied in Surgical Center of a Brazilian Large Hospital. FACEF Pesquisa - Desenvolvimento e Gestão, 23(3).
West, T. D., & West, D. A. (1997). Applying ABC to Healthcare. Management Accounting, February, 22–33. http://dx.doi.org/10.1016/j.jaci.2012.05.050
Yereli, A. N. (2009). Activity-Based Costing and Its Application in a Turkish University Hospital. AORN Journal, 89(3). https://doi.org/10.1016/j.aorn.2008.09.002
Peraturan Menteri Kesehatan no 3 tahun 2023, “Tentang Standar Tarif Pelayanan Kesehatan Dalam Penyelenggaraan Program Jaminan Kesehatan”, Menteri Kesehatan Republik Indonesia.