be well suited since it incorporates next to the advantages
of the traditional ABC system some extra features
like faster model adaptability, a simpler set-up and a
higher reflection of the complexity of the real-world operations.
The TDABC model in this paper was set up for
five different departments: Urology, Gastroenterology, Plastic
Surgery, Nose-Throat and Ears and Dermatology. Based on
cost Tables 4 and 5, the cost for a standard technical consultation
appears to range from 5.19D to 13.78D , while the
cost for a non-technical consultation ranges from 4.50D to
51.41D . The cost of a standard consultation shows already
the influence of the specificity of the consultation, the differences
in the usage of activities and machinery and the
differences in the cost per time unit. Optional activities
might then increase the cost between 0.13D and 6.77D for
a technical consultation and 0.03D and 48.83D for a nontechnical
consultation.
The TDABC system challenged healthcare managers
and department heads to identify and analyze the underlying
activities that drove the overhead costs. As such,
the TDABC analysis allowed managerial recommendations
concerning improvement opportunities [14–17,20].
Secretaries were centralized, telephone accessibility was
improved by putting head-sets available and voice recognition
systemswere introduced for all physicians to reduce
the typing times of letters. Furthermore, we also saw the
TDABC approach introduced a healthy competition and
an open communication between the different departments
concerning possible operational improvements. The
introduction of interactive meetings on business and operational
matters in thatway promoted inter-hierarchical and
more important inter-disciplinary (between physicians and
managers) communication. Finally, while the interaction
between cost-accounting systems and strategy has been
frequently viewed as a passive one [21], in this study the
TDABC information clearly improved the department heads
and healthcare managers’ understanding of the different
organizational processes. As such, the clinic’s management
was able to pursue strategic changes that increased the
value and effectiveness of the current and future outpatient
clinic.
Acknowledgements
The authors want to thank Jozef-Hendrik Melsens for
his assistance in the data collection, two anonymous HP
reviewers for their useful comments and the HP editorial
office.