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Defining clinical conditions in long-term healthcare as a first step to implement Time-Driven Activity Based Costing (TDABC)

2018-05-11Conference object Open access
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dc.contributor.authorSargento, Ana
dc.contributor.authorQuerido, Ana Isabel Fernandes
dc.contributor.authorCarvalho, Henrique
dc.contributor.authorSantos, Isa
dc.contributor.authorReis, Catarina
dc.contributor.authorMaximiano, Marisa
dc.contributor.authorFrederico, Manuela
dc.contributor.authorBernardes De Oliveira, Sandra Margarida
dc.contributor.authorLeal, Susana
dc.date.accessioned2019-03-14T10:00:39Z
dc.date.available2019-03-14T10:00:39Z
dc.date.issued2018-05-11
dc.description.abstractBackground Increasing healthcare costs is a concern of all developed countries. In Long-Term Healthcare (LTH) this is reinforced by population ageing and corresponding prevalence of chronic diseases. Thus, it is fundamental to accurately measure costs and outcomes in healthcare, improving value created for patients, i.e., patient centred health outcomes per monetary unit of cost [1, 2]. TDABC methodology applied to healthcare allows identifying the cost for each clinical condition in the full cycle of care, mapping pro cesses, activities, resources and allocated time [3 – 5]. It has been mostly applied in acute-care settings, partly due to complexity of defining chronic condition [6]. Objective This paper focuses on the cost component of a larger on-going research project (CARE4VALUE), aiming to enhance value creation in LTH providers and applied to a partner LTH unit. Specifically, the main objective is to define clinical conditions in the context of LTH, as a first step in the implementation of TDBAC. Methods Mixed qualitative and quantitative methods were applied, including: 1) three focus groups conducted with the health team of the LTH unit (physician, nurses, physiotherapist, psychologist, social assistant) to select, discuss and validate the criteria to define clinical conditions; 2) construction of a composite indicator and testing it over a sample of anonymized clinical data from 21 patients; 3) structured observation of processes taken throughout the full cycle of care of patients in different conditions. Qualitative data was submitted to content analysis and validated among participants. Quantitative data used in the composite indicator, based on validated scales, was subject to normalization, aggregation and sensitivity analysis. Results One consensual outcome of the focus groups was that, in LTH, the disease or cause of entrance is less relevant to costs than the overall complexity of the patient, entailing psychical, social, spiritual and psychic-mental dimensions. Accordingly, a multidimensional classification model of patients in four complexity levels was delivered, after being validated and receiving consensus from the LTH team. Additionally, it will include a logging tool and dashboard to integrate separate patient-centred information and aid patient classification in complexity conditions. Conclusions The completion of this step allowed progressing in the design and implementation of the cost model, which, in turn, will support value measurement, and enhancing of the focus LTH unit. Besides, all involved professionals stated that their engagement in this phase of the project generated exceptional opportunities for interdisciplinary meetings and debate, contributing to closer ties between different areas of LTH.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSargento, A., Querido, A., Carvalho, H., Santos, I., Reis, C., Maximiano, M., Frederico, M., Oliveira, S. & Leal, S. (2018). Defining clinical conditions in long-term healthcare as a first step to implement time-driven activity based costing (TDABC). Proceedings of the 4 th IPLeiria’s International Health Congress (11-12 May, Instituto Politécnico de Leiria). BMC Health Services Research, 18 (2), 684. doi: 10.1186/s12913-018-3444-8pt_PT
dc.identifier.doihttps://doi.org/10.1186/s12913-018-3444-8pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.15/2460
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMC - Springer Naturept_PT
dc.relationPOCI-01-0145-FEDER-023248 - CARE4VALUE – Potenciar a Criação de Valor em Unidades de Cuidados Continuados Integrados de Saúde geridas por IPSSpt_PT
dc.relation.publisherversionhttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3444-8pt_PT
dc.subjectLong-term healthcarept_PT
dc.subjectTime-Driven Activity Based Costing (TDABC)pt_PT
dc.subjectClinical conditionspt_PT
dc.subjectPatient-centered datapt_PT
dc.subjectPatient complexitypt_PT
dc.titleDefining clinical conditions in long-term healthcare as a first step to implement Time-Driven Activity Based Costing (TDABC)pt_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.endPage76pt_PT
oaire.citation.issue18 (2)pt_PT
oaire.citation.startPage75pt_PT
oaire.citation.titleBMC Health Services Researchpt_PT
person.familyNameSargento
person.familyNameQuerido
person.familyNameReis
person.familyNameMaximiano
person.familyNameBernardes de Oliveira
person.familyNameCristina Henriques Leal
person.givenNameAna
person.givenNameAna
person.givenNameCatarina
person.givenNameMarisa
person.givenNameSandra Margarida
person.givenNameSusana
person.identifier2975622
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person.identifier.ciencia-idC11A-1BD1-73C5
person.identifier.orcid0000-0001-5716-1890
person.identifier.orcid0000-0002-5021-773X
person.identifier.orcid0000-0003-1529-629X
person.identifier.orcid0000-0002-1212-7864
person.identifier.orcid0000-0003-4925-9227
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person.identifier.scopus-author-id35107182300
rcaap.rightsopenAccesspt_PT
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