Table 1 Steps description of the TDABC method

1 and 2

Identify the study questions and build the care process map

Care activities and procedures were identified as well as all hospital units along patient’s care pathway (five pathways identified).^a

3

Identify the main resources used in each activity and department

Resources were identified as:

- Infrastructure of hospital units (emergency, regular ward, and intensive care);

- Other resources: personnel (labor costs), medication, and exams.

4

Estimate the total cost of each resource group and department (time dependent)

- Labor costs: salaries per professional category plus related taxes;

- Infrastructure costs: hospital direct fixed costs assigned for each hospital unit.^b

5

Estimate the capacity of each resource and calculate the capacity cost rate (CCR-$/h)

- Labor: total salary divided by the contracted hours of each professional category;^c

- Infrastructure (each hospital unit): total monthly costs divided by the number of hours the unit is open per month, then divided by the number of beds.

6

Analyze the time estimates for each resource used in an activity

- Health professionals visits’ LoT: sum of time required to complete all assigned tasks related to each patient care, calculated as the multiplication of:

- Average LoT spent per care visit to patients (self-reported via online survey);

- Number of visits to each patient (collected manually from patient’s EMRs);

- Patient’s LoS: sum of time spent by patients at each hospital unit (collected manually from patient’s EMRs).

7

Calculate the overall cost of patient care

- Exam and medication: amount consumed per patient multiplied by the respective price per item;^d

- Time related resources: CCR of each resource multiplied by the time consumed by each patient and summed across all resources used along the patient’s care pathway.

8

Cost-data analysis^e

- Patients’ resource consumption and resulting costs based on care pathways and OSCI classification;

- Descriptive analysis and multivariable models.