Skip to main content
Top
Published in: Journal of Medical Systems 5/2011

01-10-2011 | Original Paper

Cost and Performance: Complements for Improvement

Authors: Paul Rouse, Julie Harrison, Nikki Turner

Published in: Journal of Medical Systems | Issue 5/2011

Login to get access

Abstract

Activity-based costing (ABC) and Data Envelopment Analysis (DEA) share similar views of resource consumption in the production of outputs. While DEA has a high level focus typically using aggregated data in the form of inputs and outputs, ABC is more detailed and oriented around very disaggregated data. We use a case study of immunisation activities in 24 New Zealand primary care practices to illustrate how DEA and ABC can be used in conjunction to improve performance analysis and benchmarking. Results show that practice size, socio-economic environment, parts of the service delivery process as well as regular administrative tasks are major cost and performance drivers for general practices in immunisation activities. It is worth noting that initial analyses of the ABC results, using contextual information and conventional methods of analysis such as regression and correlations, did not result in any patterns of significance. Reorganising this information using the DEA efficiency scores has revealed trends that make sense to practitioners and provide insights into where to place efforts for improvement.
Footnotes
1
Arguably some of these events could be partly related to the number of vaccinations and classified under the unit level. However we believed that they were more likely to be periodic.
 
2
The cost model and results can be seen in Turner et al. [10].
 
3
An output orientation measures efficiency in terms of the potential increases in output, where inputs are held constant. This contrasts with an input orientation, which measures efficiency in terms of the potential reduction in input, holding outputs constant. For CRS the efficiency score will be the same under both orientations. For VRS the efficiency score can differ.
 
4
The deprivation index provides a graduated scale of deprivation based on a number of variables from Statistics New Zealand. 1 represents the areas with least deprived scores and 10 the most deprived scores regarding socio-economic deprivation.
 
Literature
1.
go back to reference Kantor, J., and Maital, S., Measuring efficiency by product group: integrating DEA with activity-based accounting in a large mideast bank. Interfaces 29(3):27–36, 1999.CrossRef Kantor, J., and Maital, S., Measuring efficiency by product group: integrating DEA with activity-based accounting in a large mideast bank. Interfaces 29(3):27–36, 1999.CrossRef
2.
go back to reference Fried, H., Lovell, C. A. K., and Schmidt, S., Chapter 1 of The measurement of productive efficiency and productivity growth. Oxford University Press, New York, 2008.CrossRef Fried, H., Lovell, C. A. K., and Schmidt, S., Chapter 1 of The measurement of productive efficiency and productivity growth. Oxford University Press, New York, 2008.CrossRef
3.
go back to reference Charnes, A., Cooper, W. W., Lewin, A. Y. and L. M. Seiford, Data envelopment Analysis: Theory, Methodology and Applications. Kluwer, 1994. Charnes, A., Cooper, W. W., Lewin, A. Y. and L. M. Seiford, Data envelopment Analysis: Theory, Methodology and Applications. Kluwer, 1994.
4.
go back to reference Bromwich, M., and Hong, C., Activity based costing systems and incremental cost. Manag Account Res 10:39–60, 1999.CrossRef Bromwich, M., and Hong, C., Activity based costing systems and incremental cost. Manag Account Res 10:39–60, 1999.CrossRef
5.
go back to reference Mota, S., Benzecry, J. H., and Qassim, R. Y., A model for the application of data envelopment analysis (DEA) in activity-based management (ABM). Int J Tech Manag 17(7/8):861–869, 1999.CrossRef Mota, S., Benzecry, J. H., and Qassim, R. Y., A model for the application of data envelopment analysis (DEA) in activity-based management (ABM). Int J Tech Manag 17(7/8):861–869, 1999.CrossRef
6.
go back to reference Singer, M., and Donoso, P., Empirical validation of an activity-based optimization system. Int J Prod Econ 113:335–345, 2008.CrossRef Singer, M., and Donoso, P., Empirical validation of an activity-based optimization system. Int J Prod Econ 113:335–345, 2008.CrossRef
7.
go back to reference Homburg, C., Using data envelopment analysis to benchmark activities. Int J Prod Econ 73:51–58, 2001.CrossRef Homburg, C., Using data envelopment analysis to benchmark activities. Int J Prod Econ 73:51–58, 2001.CrossRef
8.
go back to reference Homburg, C., Using relative profits as an alternative to activity-based costing. Int J Prod Econ 95:387–397, 2005.CrossRef Homburg, C., Using relative profits as an alternative to activity-based costing. Int J Prod Econ 95:387–397, 2005.CrossRef
9.
go back to reference Soteriou, A. C., and Zenios, S. A., Using data envelopment analysis for costing bank products. Eur J Oper Res 114:234–248, 1999.CrossRefMATH Soteriou, A. C., and Zenios, S. A., Using data envelopment analysis for costing bank products. Eur J Oper Res 114:234–248, 1999.CrossRefMATH
10.
go back to reference Turner, N., Rouse, P., Airey, S., and Petousis-Harris, H., The cost of immunising at the general practice level. J Prim Health 1(4):286–296, 2009. Turner, N., Rouse, P., Airey, S., and Petousis-Harris, H., The cost of immunising at the general practice level. J Prim Health 1(4):286–296, 2009.
11.
go back to reference Cooper, R., and Kaplan, R. S., The design of cost management systems. Prentice-Hall, Englewood Cliffs, 1991. Cooper, R., and Kaplan, R. S., The design of cost management systems. Prentice-Hall, Englewood Cliffs, 1991.
12.
go back to reference Kaplan, R. S., and Anderson, S. R., Time-driven activity-based costing. Harv. Bus. Rev. 82(11):131–138, 2004. Kaplan, R. S., and Anderson, S. R., Time-driven activity-based costing. Harv. Bus. Rev. 82(11):131–138, 2004.
Metadata
Title
Cost and Performance: Complements for Improvement
Authors
Paul Rouse
Julie Harrison
Nikki Turner
Publication date
01-10-2011
Publisher
Springer US
Published in
Journal of Medical Systems / Issue 5/2011
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-010-9520-1

Other articles of this Issue 5/2011

Journal of Medical Systems 5/2011 Go to the issue