Developing a Cost Data Collection Framework for Tuberculosis Care Using Activity-Based Costing: In-Person and Digital Strategies
1
1. São Paulo State Department of Health, Ribeirão Preto, Brazil
2
2. Salesian University Center of São Paulo, Americana, Brazil
3
3. University of São Paulo, Ribeirão Preto, Brazil
4
4. State University of Western Paraná, Foz do Iguaçu, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Cost estimation in health services requires instruments capable of systematically and contextually capturing the complexity of care delivery, administrative, and surveillance processes (1,2). In tuberculosis (TB) care, particularly under Conventional Directly Observed Treatment (DOT) and Video Directly Observed Therapy (vDOT), the diversity of activities, professionals, and resources involved poses challenges to accurate cost measurement(3). In this context, activity-based costing represents an appropriate approach(1,4,5). This study aimed to develop and apply an instrument to collect cost data related to TB treatment under in-person and digital strategies.
METHODS:
This methodological study developed and applied a semi-structured instrument for cost data collection, grounded in the activity-based costing method(1,2). The instrument identified activities, involved professionals, time spent, resources consumed, and cost drivers across care delivery, administrative, and health surveillance processes. The instrument was reviewed by the project team and by a researcher experienced in activity-based costing, followed by pre-testing with managers and healthcare professionals from TB reference services. The study was approved by a Research Ethics Committee, and data collection was conducted between January and December 2025.
RESULTS:
A total of 22 participants were included, comprising 5 health managers and 17 healthcare professionals, predominantly female, with a mean age ranging from 43 to 49 years. The instrument enabled detailed mapping of activities, average execution times, labor use, consumption of supplies, diagnostic tests, and travel, supporting cost allocation based on actual resource consumption. It proved to be clear, feasible, and sensitive to the operational specificities of health services.
CONCLUSIONS:
The use of a semi-structured instrument guided by activity-based costing constitutes a methodological strategy for collecting cost data in health services. It contributes to more accurate economic analyses and supports evidence-informed decision-making in public health policies.
Cost estimation in health services requires instruments capable of systematically and contextually capturing the complexity of care delivery, administrative, and surveillance processes (1,2). In tuberculosis (TB) care, particularly under Conventional Directly Observed Treatment (DOT) and Video Directly Observed Therapy (vDOT), the diversity of activities, professionals, and resources involved poses challenges to accurate cost measurement(3). In this context, activity-based costing represents an appropriate approach(1,4,5). This study aimed to develop and apply an instrument to collect cost data related to TB treatment under in-person and digital strategies.
METHODS:
This methodological study developed and applied a semi-structured instrument for cost data collection, grounded in the activity-based costing method(1,2). The instrument identified activities, involved professionals, time spent, resources consumed, and cost drivers across care delivery, administrative, and health surveillance processes. The instrument was reviewed by the project team and by a researcher experienced in activity-based costing, followed by pre-testing with managers and healthcare professionals from TB reference services. The study was approved by a Research Ethics Committee, and data collection was conducted between January and December 2025.
RESULTS:
A total of 22 participants were included, comprising 5 health managers and 17 healthcare professionals, predominantly female, with a mean age ranging from 43 to 49 years. The instrument enabled detailed mapping of activities, average execution times, labor use, consumption of supplies, diagnostic tests, and travel, supporting cost allocation based on actual resource consumption. It proved to be clear, feasible, and sensitive to the operational specificities of health services.
CONCLUSIONS:
The use of a semi-structured instrument guided by activity-based costing constitutes a methodological strategy for collecting cost data in health services. It contributes to more accurate economic analyses and supports evidence-informed decision-making in public health policies.
| eISSN: | 2654-1459 |
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