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Health Economics and Management

Costing of healthcare services in Bulgaria – guidelines for implementing some good practices

Mincho Minev, Lyubomira Koeva-Dimitrova


Costing of healthcare services is one of the most severe challenges facing hospitals’ accounting and management teams.
The article presents the characteristics, advantages, and limitations of three different approaches to costing medical services – Time-Driven Activity-Based Costing, Target Costing, and Micro-Costing. We provide a summary of the
international experience in their application, and guidelines for their implementation in the Bulgarian context.
Aligning the costing systems with current developments in the management accounting field has the potential to improve hospitals’ cost management and their financial condition.
At a health system level, accumulating reliable information on the actual cost of medical services would facilitate the
process of setting fair reimbursement prices and thus result in more effective ways to spend the scarce resources.


Cost; Costing; Health care; Time Driven Activity Based Costing; Target Costing; Micro Costing

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