Operating Room Management Accounting and Cost Calculation Model for Operating Rooms

Healthcare organizations are actually facing a paradoxical situation where resources are decreasing just as and costs and demand for services are increasing (Callahan, 1999). The economic and financial crisis has also had an important impact on the healthcare sector. Available resources have decreased, while at the same time costs as well as demand for healthcare services are on the rise (Mladovsky et al., 2012; Oduncu, 2012). In view of this, health managers are under pressure to create and implement increasingly efficient Information Technology (IT) operating tools able to guarantee the sustainability of the healthcare sector, with a specific emphasis on efficiency (McKee et al., 2012). This means to create management accounting tools to monitor and therefore improve activities’ efficiency. In doing so, physician behavior often is of impediment to the development or expansion of information systems. In part, their resistance is typically due to their decision-making processes that do not include efficiency considerations. As a result, clinicians may perceive the introduction of economic measurement tools as distant from their values and perhaps even as a direct attack to their professional norms (Young, 1985). Hospitals are essential components in providing overall healthcare. Hospitals consume, on average, between 50% (in Western Europe) and 70% (former Soviet Union) of the overall country’s healthcare budget ‘(...) makes them the obvious targets for governments trying to cap public expenditure or to slow the rate of growth’ (McKee & Healy, 2002). Operating rooms (ORs) are critical hospital units both in terms of patient safety and in terms of expenditure. In fact, understanding OR procedures in a hospital provides important information about how a consistent portion of health care resources are used (Elixhauser & Andrews, 2010). The aim of this article is to showcase how the implementation of management accounting tools can be fostered through IT tools already in use for other “patient-centered” purposes. The e-HCM (e-Healthcare Cost Management) consists of a cost per procedure calculation model that gets information about resources used from an IT tool already in use for risk management in an operating room (OR). Direct costs of all Matteo Buccioli Morgagni-Pierantoni Hospital, Italy