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1. Costing Healthcare Services Using Time-Driven Activity-Based Costing: A Simple Step-By-Step Guide for Data Collection and Analysis

Author:
Lumbwe Chola, Ryan McBain, and Y-Ling Chi
Publication Date:
10-2022
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Cost information is essential for priority setting and optimized resource allocation in the healthcare sector, especially in low- and middle-income countries (LMICs) where resource constraints and opportunity costs are significant. In recent years, a costing approach labelled time-driven activity-based costing (TDABC) has gained prominence, as a means for more closely estimating unit costs. TDABC is a process-based micro-costing methodology that adopts a patient perspective to identify resources that are allocated over the course of service provision, mapping each step of a patient journey. Unlike other activity-based costing methods, TDABC includes the recording of the amount of time that resources are utilized for each activity. The manuscript is developed as a step-by-step guide for researchers, students and policy makers intending to undertake TDABC. While there are many academic resources explaining the theory and steps to conduct TDABC, in this paper, we provide easily accessible descriptions of methods for collecting data, tools that can be adapted to diverse research questions and settings, as well as practical data collection “tips” we learned from applying approaches on the ground.
Topic:
Science and Technology, Health Care Policy, Medicine, and Cost-Benefit Analysis
Political Geography:
Global Focus

2. A Path to Resiliency: Mitigating the Impacts of COVID-19 on Essential Medicines Supply Chains

Author:
Anthony McDonnell, Elizabeth Pisani, and Somya Singhvi
Publication Date:
06-2021
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
COVID-19 has put a spotlight on health product supply chains, highlighting the challenges in multiple steps in the global supply chain. This paper seeks to understand the impact of COVID-19 on the supply chain of a subset of essential medicines. It identifies the main categories of blockages in the global supply chain created by COVID-19, then uses data on trade flows, wholesalers, and pharma companies, and from surveys, to track the impact. There was significant short-term disruption to manufacturing caused by COVID-19. Surveys, pharmacy, and export data indicate that COVID-related disruptions impacted the supply of essential medicines, but this varied greatly by markets and product. The paper highlights that (1) data-driven approaches should be considered to make supply chains more robust, (2) solutions must account for the political and institutional landscape, (3) price surges benefit the wealthiest, and (4) local solutions are often needed to manage global shocks. More research is needed, particularly into how to obtain granular data to track supply shocks in real time? How do we increase surge capacity? Is it possible to improve procurement practices through pooled procurement, where applicable? And can pharmaceutical production be diversified, with products produced regionally to limit the risk of disruption?
Topic:
Pandemic, Resilience, COVID-19, and Medicine
Political Geography:
Global Focus