Cost Efficiency Analysis with the Application of Activity-Based Management A Case Study of Inpatient

Background: Hospitals require accurate activity-level cost information to control expenditures while maintaining service quality. At Aisyiyah Muntilan Hospital, discrepancies between inpatient tariffs and activity-based costs highlight potential inefficiencies and tariff distortions. Objective: This study aims to evaluate inpatient cost efficiency using Activity-Based Costing (ABC) and Activity-Based Management (ABM), identify non-value-added activities, and recommend cost optimization strategies. Methods: This study analyzed primary and secondary data from 2023. Primary data were collected through interviews with relevant hospital personnel and direct observations of inpatient activities. Secondary data included financial records, operational cost distribution documents, and hospital records. ABC was applied to calculate inpatient unit costs, while ABM identified non-value-added activities and estimated potential cost reductions. Results: ABC calculations revealed daily inpatient unit costs of IDR 266,995 (VIP), IDR 259,026 (Class 1), IDR 219,821 (Class 2), and IDR 227,087 (Class 3). Compared with existing tariffs, VIP generated a surplus of IDR 93,005, while Classes 1, 2, and 3 experienced deficits of IDR 4,026, IDR 39,821, and IDR 72,087, respectively. Five of 29 inpatient activities were classified as non-value-added, accounting for IDR 383,792,665 (5.58%) of total activity costs. Their elimination could reduce estimated unit costs to IDR 244,869, IDR 239,032, IDR 203,995, and IDR 204,688, respectively. Conclusion: Integrating ABC and ABM identifies tariff discrepancies and potential cost savings. Achieving these efficiencies requires process improvements and operational adjustments without compromising healthcare quality.