Eintrag in der Universitätsbibliographie der TU Chemnitz
Volltext zugänglich unter
URN: urn:nbn:de:bsz:ch1-qucosa2-840564
Schultz, Charles Albino
Götze, Uwe (Prof. Dr. Prof. h. c.) ; Peças, Paulo Miguel Nogueira (Prof. Dr. ) (Gutachter)
A user-oriented Target Costing instrument for primary healthcare services cost management for the Brazilian Unified Health System
Kurzfassung in englisch
The Brazilian Unified Health System (UHS) primary care services are provided by several structures scattered over more than five thousand municipalities. The Primary Care Units (PCU) are the most common structures, and are the basis of the system providing a large volume of services to most Brazilian populations. The operational management is under the responsibility of the municipalities, while the funding, policies, and strategic management are shared with the Union and the municipality’s state. In this context, municipal managers usually face several challenges in understanding the local population’s needs, managing service quality and users’ satisfaction, determining and managing service costs, and measuring service performance. As a rule, managers do not have advanced management tools, and the planning of services and service costs is carried out through annual plans and actions that define how many services should be provided and the total amount of funds to cost these services. When annual planning starts, most costs are already committed, because most of them are fixed and difficult to influence after starting the service delivery. For more efficient cost management, it would be appropriate to influence PCU costs during the planning phase, before starting the service delivery.In order to contribute to primary healthcare services management, this study aimed to develop a user-oriented Target Costing instrument for cost management of primary care services in the UHS. Target Costing is best known in the industry, and its use in healthcare and public services can still be considered incipient. In typical market situations, Target Costing derives the target cost by subtracting the target profit from the target price. However, public primary healthcare services are free of charge and do not have selling prices. Furthermore, Brazilian public accounting does not measure the financial results through profit or loss. The literature presents Economic Management (EM) as a way to overcome this challenge. The EM concepts are suitable for measuring the result when sale prices are unavailable or commercialised. EM includes the concepts of “opportunity revenue” replacing the sales prices and revenues, and “economic result” replacing profit or loss. Using these two concepts allows the implementation of phases 3 and 4 of the Target Costing process, similarly to the traditional way.
The instrument integrates the Servqual and the Kano Model in regard to hearing the voice of the users. Servqual has been frequently applied to collect data on expectations and perceptions of quality from the users of health services. Both tools enable the development of indicators that represent the importance attributed to quality items in the quality gap, customer satisfaction index, and the Kano categories.
Another relevant point to the Target Costing instrument is the connection of the user’s given importance to quality requirements and the service characteristics, processes, and the employed resources and employee groups. This connection is developed by deploying quality requirements using the Quality Function Deployment (QFD) process. QFD also supports the new service and new PCU design process. The instrument also integrates the Time-Driven Activity-Based Costing (TDABC), which assumes a relevant role in organising the cost accounting and supports the design activities.
Simulating the instrument’s application to a fictitious case shows a suitable cost management approach in the planning and design phases of the new PCUs, respecting the main Target Costing fundamentals and achieving the primary objective of this study.
| Universität: | Technische Universität Chemnitz | |
| Institut: | Professur BWL III - Unternehmensrechnung und Controlling | |
| Fakultät: | Fakultät für Wirtschaftswissenschaften | |
| Dokumentart: | Dissertation | |
| Betreuer: | Götze, Uwe (Prof. Dr. Prof. Dr. h. c.) | |
| URL/URN: | https://nbn-resolving.org/urn:nbn:de:bsz:ch1-qucosa2-840564 | |
| SWD-Schlagwörter: | Zielkostenrechnung , Kostenrechnung , Gesundheitswesen | |
| Freie Schlagwörter (Englisch): | primary healthcare services , patient orientation , market orientation , cost management , cost planning , Unified Health System , Target Costing , Quality Function Deployment , Servqual , Kano Model , Time-Driven Activity-Based Costing | |
| DDC-Sachgruppe: | Management, Öffentlichkeitsarbeit | |
| Sprache: | englisch | |
| Tag der mündlichen Prüfung | 07.02.2023 |
