Cost data takes the form of figures from the General Ledger associated with cost centres and subjective account codes. Some may match clinical categories, e.g. if a cost centre correspond to a specialty, while others may cut across clinical categories.
The first step in the Ardentia approach is to view costs as covering a series of components of care, resources such as ward nursing, diagnostic services, medical time, the different elements of theatre provision (nursing, surgeons, anaesthetists, consumables, premises), etc. The categories used should correspond to the cost buckets used for reference costing. We then:
• Map finance data onto these component resources for healthcare.
• Agree with clients the weightings to be used to apportion semi-fixed costs across patient activity records, at the lowest possible level: where costs are available at ward level, then
allocate them to ward stay records; otherwise allocate them to FCEs and attendances.
• If weightings can be derived directly from activity data (e.g. theatre minutes, bed days or hours, attendances) the system calculates them, otherwise it provides
functions to enter them by hand.
• Apportion actual costs to the activity records
• Assign direct costs to the relevant patient records wherever possible.
Care has to be taken to follow the logic of patient record structures to ensure that allocations are accurate. For example, FCEs and ward stay records may overlap.
Making the Results Available
Like all Ardentia solutions, Patient Level Costing delivers its reports over the web. This means that all you have to do is give any user you want access to your network, specifying what information and what reports he or she can see. The user needs no software other than astandard web browser.
All the usual functions of web consultation are available: clicking on reports to open them, drop down menus, drill down from level to level of reports. In addition, Arden- tia provides for ‘drill-through’ so that once a user with the appropriate access rights has identified a particular area of interest, say results for one specialty, practice and month, he or she can extract the corresponding individual patient activity records.