Case Costing

At What Cost? We’re on a journey to find the answer.

We know Nova Scotia Health Authority (NSHA) is a community of people who provide excellent health care.

The unknown is how much that care costs. With an uncertain economic climate, escalating health care spending and an aging population, it’s more important than ever for us to find out. To that end, NSHA has implemented case costing to the organization.

What Exactly is Case Costing?

It’s an accounting method that captures full costs of specific procedures and episodes of care by calculating all direct and indirect costs. The numbers can answer a host of questions.

For Example

  • How much does a lens implant cost at the QEII?
  • How does that compare with the procedure done elsewhere and how do outcomes compare?
  • How can we use that information to improve care? 

Over the last two years, NSHA - Central Zone has applied case costing to all clinical areas. During that timeline, we employed the standards and practices that enabled us to case cost: MIS, appropriate cost allocation and workload measurement. Planning and working teams provided support for each of these case costing components.

What Case Costing Means for NSHA

Case costing is a long-term journey with twists, turns and bumps - and ultimately benefits we will all share. As we implemented the practical steps toward case costing, we also took greater steps to reposition and strengthen our ethical and evidence-informed decision making. We gained a better understanding of the services we provide, when, for whom, by whom and at what cost. We will use this information and knowledge to make comparisons, to do analysis, to evaluate, to make decisions, to make changes. Along the way, we are moving from “We think...” to “We know...”

From the clinical areas to the meeting rooms to the boardrooms at NSHA, when we are faced with a dilemma, we will have the information we need to make the best decisions possible. When asked why, we will provide sound reasoning supported by solid evidence. When we think there is a better way, we will have the facts to make the strongest case for change. When the change is made, we will evaluate it thoroughly and effectively.

Where can I find case costing data?

High level reports are available on the our intranet. Clinical areas that have been identified as areas of focus have additional information available to them.

Report Caveats

  • Physician costs are not included
  • Operating room supplies are not traced directly to individual patients
  • Capital Equipment purchased from January 2012 onward is amortized at the cost centre level
  • Data has not been validated by the Canadian Institute for Health Information (CIHI)
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