OBJECTIVES : Healthcare studies contemplating the TDABC method have increased in recent years, mainly driven by the need for greater precision in cost estimation. Although several organizations are already implementing the method, some issues still lie in the estimation of cost capacities rate (CCR) and in consideration of indirect costs. This review analyzed if the researchers, when performing TDABC studies, are applying specific methods to estimate CCRs and distribute indirect costs.

METHODS : Pubmed/Medline and Scopus databases were used to conduct the search in October 2019 by the string: “time-driven activity-based costing” and “healthcare.” One researcher reviewed the title and abstracts, using as selection criteria papers that applied TDABC in a healthcare organization. In sequence, the same researcher reviewed the full texts and using as criteria the confirmation of TDABC use and detailed information about the resources, their capacity estimation, and the indirect costs consideration, included the studies in the sample to be evaluated.

RESULTS : 88 studies were identified, and 37 were included in the sample. The key resources considered are labor cost (100%), equipment (57%), supplies (54%), and space (43%). The majority of organizations (70%) estimated the CCRs using an analytically calculated practical capacity, and a few using an arbitrary practical (19%) or theoretical capacity (11%). None of the organizations used more than one capacity estimation. For the indirect costs, most organizations (65%) didn’t consider them during the application of the method. Among those who used, “overhead costs” expression was pointed to explain what was considered by the distribution that traditional cost systems already do.

CONCLUSIONS : The practical capacity is a positive calculation being applied by healthcare organizations, but the non-consideration of different capacities makes it challenging to identify cost-saving opportunities. There is no exploration of overhead costing accurate methods, which represents an issue to be studied to increase the quality of TDABC in healthcare.