Measuring the cost of a product is complicated when the products are services that are aimed at people, given that multiple variables are considered.
When talking about the cost of nursing services, one of the main problems we face is the omission of variables. Also, there is a lack of data comparison, in addition to the multiple definitions of cost.
There are multiple variables that may be absent, mainly those related to invisible care. How much time does the nurse spend on invisible care? More importantly, what is the value of this care in relation to the health process and to the well-being and satisfaction of the patient? And what does it have to do with the quality of service felt?
It becomes essential to establish models with the ability to describe nursing processes and also to describe the relationships established by the patient and their relationship with the cost, quality and price of nursing functions.
Therefore, it would be a mistake to consider the direct and indirect costs of nursing care, which are covered by different methodologies such as DRGs. The calculation of the costs of nursing services must be carried out in accordance with care plans, to which we must add the time that the nurse dedicates to what we have called invisible care (emotional support, comfort, attention to solitude, active listening, attention to mourning, despair…).
One possible solution to achieve real cost measurement, can be the implementation of ABC cost systems. Under this methodology, costs are accumulated through the different activities that are carried out and consume resources (people and materials) and are attributed to each of the patients.
In order to implement a costing system under the ABC method, we must consider three stages:
Identification of the activities carried out by the nurse (visible and invisible)
Assessment of the cost of each of these activities, trying to establish the consumption of resources required to carry out these functions with consideration for quality standards.
Allocation of costs to each activity or cost object. A cost object is all that is necessary to carry out a measurement in an isolated way. This ends with the establishment of the unit costs of each of the units of care activities.
The ABC method allows us to make a differentiation that GRD-guided methods do not allow, such as the costs of non-quality and lack of efficiency.