Management Accounting Techniques for Cost Measurement in Value-Based Healthcare: A Systematic Review

Background: Accurate cost measurement is a critical prerequisite for implementing value-based healthcare (VBHC), particularly in public healthcare systems and academic medical centers, where financial constraints and resource complexity require precise cost accounting. Traditional costing methods often lack transparency and accuracy, limiting their usefulness for managerial decision-making. Objective: This systematic review evaluates management accounting cost measurement methods used in public hospitals and academic medical centers, with a particular focus on Time-Driven Activity-Based Costing (TDABC), and examines their effectiveness in improving cost accuracy, transparency, and healthcare efficiency. Methods: A systematic review was conducted in accordance with PRISMA ۲۰۲۰ guidelines. PubMed, Scopus, Web of Science, and Embase databases were searched for peer-reviewed studies published between ۲۰۰۴ and ۲۰۲۴. Studies evaluating healthcare costing methodologies in hospital settings were included. Data were extracted on costing method, healthcare setting, accuracy, and operational impact. Results: A total of ۱,۹۳۰ records were identified, and ۲۱۵ studies met inclusion criteria. TDABC was the most frequently used advanced costing methodology. Compared with traditional costing methods, TDABC demonstrated superior accuracy, improved cost transparency, and enhanced identification of cost drivers. Studies reported significant improvements in resource allocation, operational efficiency, and support for value-based healthcare implementation, particularly in public hospitals and academic medical centers. Conclusion: TDABC represents the most accurate and effective cost measurement approach for public healthcare systems and academic medical centers. Its adoption supports value-based healthcare implementation, improves resource allocation, and enhances financial sustainability. Healthcare policymakers and hospital administrators should consider TDABC as a strategic tool for improving healthcare system performance.

کلیدواژه ها:

Time-Driven Activity-Based Costing ، Value-Based Healthcare ، Public Hospitals ، Academic Medical Centers