Cost Accounting in teaching hospitals: an application in a surgery unit

The Italian Healthcare National System is involved in a deep process of change aimed at diffusing managerial techniques used in the private sector to public administrations. In this context, an extensive literature on healthcare planning and control systems (PCSs) is growing. PCSs are characterised by a complex architecture made up of three elements: the process infrastructure, the organisational infrastructure and the technical infrastructure. In this paper, we focus on the technical infrastructure and, in particular, on the logic of cost accounting in teaching hospitals. The paper presents a case study on the allocation of surgery unit costs on final cost centres that use its services. The proposed application is part of a wider project involving the Azienda Ospedaliera Universitaria Federico II (AOU Federico II) and the Department of Business and Managerial Engineering at University of Naples Federico II. The project aims at implementing a cost accounting system in AOU Federico II. In addition to the allocation model, the paper offers some observations derived from the case study and on the importance of integration among the infrastructures of PCS.