The present work tries to expose the usefulness of the teaching of costs and its applications focused on the health sphere, in the curricular training of future university accountants, through the teaching of an optional subject in the final years of the degree..
The teaching of the main cost tools that make planning, calculation and analysis in accordance with the legislation in the country possible, the approach to new trends at the international level and comparisons with other realities, contribute to the formation of values and achieve better professionals for society.
Through the research work presented by the students, the main results achieved are focused, which constitute the fundamental diagnosis of the knowledge incorporated into learning.
Summary
The present work intends to present the benefits of the teaching of the costs and its applications focused toward the sphere of the health, in the curricular training of the future university accountants, through the teaching of an optional subject in the final years of the studies. The teaching of the main tools of the cost that facilitate its planning, calculation and analysis in correspondence with the legislation in the country, the approach toward the new trends at an international level and the comparisons with other realities, contribute to the formation of values and to obtain better professionals for the society. The research works presented by the students center on the main reached results that constitute the fundamental diagnosis of the knowledge incorporated to the learning.
Introduction
The formation of values constitutes an essential objective in Cuban Education, that is why in higher education special attention is devoted to educational projects where we must achieve in the student the love of the profession. In the study plan of the Accounting and Finance program, the discipline "Cost" is called to equip the future professional with advanced techniques used in the international field of Accounting for managerial purposes through the creation of skills. that allow solving specific problems of our organizations with responsibility, honesty and ethics.
The discipline is structured in four basic subjects and as the students pass through these subjects, the proposed objectives must be achieved. On the other hand, the study plan conceives the teaching of elective and elective subjects that are aimed at providing the future professional with knowledge that contributes to developing and updating the knowledge that is acquired during their curricular training with the purpose of guaranteeing professional society. of excellence.
The teaching of an optional subject aimed at the study of costs and their particularities in the health sector, enables the student to expand his knowledge of the discipline and learn about its applications in a sphere of services with very special characteristics that is not addressed during the race.
In Cuba, greater control and administration of costs is required, since access to the most essential resources is difficult as a consequence of being an underdeveloped country affected by the economic blockade. Given the increase in the amounts of investments and the amounts allocated to health actions; Every day the need to know the costs of the different types of health institutions becomes more important, as a way to help optimize the resources allocated for this purpose by the State budget. The costs make it possible to reflect the efficiency achieved by constituting a working tool for administrative management in the different branches of the National Health System as an organization.
I.- Background and design of the subject program
The optional subjects are those that are included in the study plan and from which the student selects a certain amount to study on a compulsory basis. The contents of these subjects are intended to expand and update students on scientific topics related to the profession.1
The study plan of the career in relation to the discipline "Costs" is aimed at the business environment, in order that students through educational and instructional objectives, understand the importance of production costs in and for the managerial process, based on the recognition of the main conceptions of Marxist-Leninist theory and highlights the presence of other sectors of the economy of special importance for the sustainability of society, which are linked to the sphere of services in which there are those destined for health, but these do not constitute the object of study of the subjects taught.
In consideration of these aspects and as a way to expand the knowledge that students acquire during the learning of the Cost subjects, the discipline is proposed to teach an optional subject that has been called “Cost management in the health sector ”, with enough attributes to help consolidate cost tools in correspondence with the peculiarities of health services.
The antecedents of this purpose are in the linkage of some investigations to this sector since 2006, most of them carried out with the participation of students, who carried out their diploma work as part of the culmination of career studies. The joint participation of the Ministry of Public Health, other centers and the Department of costs of the Faculty of Accounting and Finance led to the successful conduct of these investigations. As a result, in all cases, a high motivation was obtained for seeking practical solutions to the problems raised, which had their genesis in the need to use cost information for management.
The course program proposes a duration of 45 hours and sets as a general objective to know the need for the use of cost information for entities of the health system, beginning by explaining their peculiarities and developing case studies that illustrate how to apply the information of costs for planning, analysis and decision making.
As a closing evaluation of the subject, a workshop seminar is proposed where the students grouped by teams present the results of the diagnosis carried out in a selected health institution, based on a guide of aspects to consider related to the topics covered in the subject.
II. Application of the program and results obtained
The subject was taught weekly to students in the 4th year of the degree, considering three topics as explained below, with the content per week according to P-1 shown in Annex 2. It was taught in parallel with the subject Cost for Control and Decision Making and after having passed through three cost subjects that provided him with the basic knowledge of the discipline.
Topic I: "Costs in the health system" addresses as content the importance and need for costs, their basic foundations, terminology and definitions. The particularities of the Cuban health system and the cost system for hospitals. It is noteworthy that in this topic it is highly relevant to explain the characteristics that distinguish the sphere of health services, with emphasis on the peculiarity of this sector in Cuba with new and unique characteristics. The health sector reflects the Cuban socialist society as a whole, is subsidized by the State and is based on the needs of the population and not on financial solvency relationships, working with a set of measures aimed at achieving greater efficiency in the provision of services and teaching, preserving equity,effectiveness and accessibility, in a situation of limited resources.
In this topic, we work with the Health Costs Instructions and Procedures Manual2, developing practical examples based on these considerations. Classification and multiple selection exercises were developed.
Topic II: "Planning, calculation and analysis of costs". It develops illustrative examples about the planning and budgeting process referred to the characteristics of these services, taking up the application of the knowledge they acquired in the previous subject: "Default Costs". It is important to highlight on this topic how to control compliance with the system of principles that regulate Cuban Public Health, the State has control channels:
- A methodological way that is represented by the different instances of the Ministry of Public Health: municipal, provincial and national that regulates procedures and techniques in the different stages of health intervention.
- An administrative channel in charge of controlling the execution of the budget, finances and use of human and material resources in the different programs, represented by the different instances of the state popular power.
On the other hand, for the analysis process, the economic evaluation techniques are taught based on cost, which are applied from the examples proposed in classes.
Topic III: “Procedures for determining costs in the health sector. Current trends ”, proposes to explain through cases of national and international health institutions with dissimilar characteristics, the different routes used to determine their costs and the possibilities they offer for analysis, control and decision-making. The strategic approach to be applied by the health center is highlighted, considering that the management culture allows, thanks to the application of technical tools, to improve the organization of services, avoid the misuse of resources and useless activities, rationalize and articulate the different clinical, industrial, medical-technical, logistical and administrative activities aimed at a single purpose: patient health.
The case studies that are addressed in the course are aimed at integrating knowledge of costs on the one hand and their application to the peculiarities of the institutions belonging to the health services sphere, on the other hand, not included in the study.
The bibliography used during the course were the materials prepared by the teachers from existing normative documents in the country, specialized bibliography of national and international character, the research and diploma papers and some materials obtained through their search in Internet.
The seminar-workshop that is carried out as the final activity of the subject to evaluate the learning results by the students, consists of the orientation of a work through a guide, which guides on the fundamental aspects to be taken into account in the diagnosis to the selected health center and its purpose is to apply the knowledge acquired in the subject and explain their experiences.
In carrying out this activity, the following aspects were revealed:
- There was motivation on the part of the students in carrying out and discussing the work.
- The application of the contents studied was appreciated.
- A favorable exchange was achieved between the students during the development of the activity, which allowed them to make comparisons between the areas under analysis and determine positive and negative aspects that currently exist related to this topic.
There were limitations on the part of several centers to support the performance of the work, in some because they did not have the required cost information, nor did they have specialists in the accounting area, and in others due to the lack of willingness and possibilities of accounting personnel to provide assistance. to the students.
- Working with costs is a weakness that most of the centers studied have.
Conclusions
The teaching of an optional subject in the final years of the Accounting and Finance career, which addresses the issue of cost management in the field of health, contributes to:
• The formation of values, by bringing the student closer to a sector of the Cuban nation that constitutes one of its greatest social achievements.
• Consolidate and expand knowledge of the discipline in a sector of the service sphere that is not studied during their academic training.
• Creation of skills to propose solutions to specific problems of current practice in the country.
• Motivate future accountants to become part of the professionals linked to the health sector.
• Join research projects focused on this topic.
• Train a professional more prepared for Cuban society.
- Aldo S. Torres Salinas. CP.y M. Cost accounting. Analysis for decision making. Revised edition. McGraw-hill.
- Cosilla i Pueyo, Delfí, Clinical Management and hospital management. Information service. Ediciones Harcourt, SA 2008. Pages 75.
- Fernández Caballero, E; Castell-Flont Serrate, Pastor; Health Management. Management Training System. Selection of themes. December 1997 Volume I.
- Horngren Charles, T. Cost Accounting, Part One, Part Two, and Part Three. Havana: 1991, - Horngren Charles, T, Datar Srikant M, Foster G. Cost Accounting a managerial approach. Twelfth Edition. 2007
- Ministry of Higher Education. (MONTH) 2009. Program of study plan “D” of the career “Degree in Accounting and Finance”
- Ministry of Higher Education. (MONTH) 2009. Discipline program "Costs" plan "D".
- Ministry of Public Health. Finance and Accounting Department. Manual of Instructions and Procedures of Health Costs. 2009
- Ministry of Higher Education. Republic of Cuba. Teaching and methodological work regulations. Resolution No. 210/2007. Chapter II. Article 70
- Pan American Health Organization. 2001. The transformation of Hospital Management in Latin America and the Caribbean.
- Ramos Domínguez, N; Alderegia Henríquez, J. Social medicine and public health in Cuba. Editorial Pueblo y Educación 1990. Pages 36-41, 105-122, 149, 183.
- Suárez Jiménez, A; Cruz Ledesma, Yadelis and others. Considerations on costs in Cuban hospital services. September 2007.
Ministry of Higher Education University of Havana
Faculty of accounting and finance Discipline: Costs Study plan “D”.
Optional subject: Cost management in the health sector. Face-to-face modality.
I.- General objectives of the subject: Educational:
Contribute to:
• Achieve an awareness of the importance of costs for the managerial process, in the sphere of health services.
• Use the bibliography and available materials that contribute to the development and updating of their knowledge.
• Form a personality with ethical and professional values that respond to the needs of our economic and social environment.
Instructions:
• Learn the systems, techniques and procedures for the use of costs by entities of the health system in Cuba and the experiences of the international environment.
Knowledge system:
Particularities in the sphere of health services. The Cuban health system. Importance and need for costs. Basic fundamentals. Terminology and definitions. Classifications. The cost system in Cuba and the Instructions and Procedures Manual. Particularities. Importance of its use for the management of hospitals and differentiated health services. Costs and the budget process. Usefulness of cost information for planning and budget control. Use of budgets.
Cost determination procedures. Costs of hospital products. Activity costs. Costs by disease groups. Patient costs. Economic evaluation in health services. Usefulness of your application.
Skill system:
• Identify the particularities of health services.
• Know the requirements for the application of costs in entities of the Cuban health system.
• Apply the techniques and procedures for budgeting, calculation and cost analysis in the health services sector.
II - Thematic plan:
Frequent assessment: Control questions, practical classes and case discussion.
Final Evaluation: Team workshop seminar.
VI.- Bibliography
• Ministry of Public Health. Finance and Accounting Department. Manual of Instructions and Procedures of Health Costs. 2009.
• Horngren Charles, T. Cost Accounting, Part One, Part Two, and Part Three. Havana: 1991, On digital media
• Ramos Domínguez, N; Alderegía Henríquez, J. Social medicine and public health in Cuba. Editorial Pueblo y Educación 1990. Pages 36-41, 105-122, 149, 183.
• Works of diplomas, theses of masters and specialties.
• Digitized Articles of national and international origin.
The Health Sector.
In the event that some of the required information does not exist, the student must design a proposal based on the possible scenarios. See examples analyzed in classes.
Aspects to consider:
1. Characterization of the Institution.
2. Organizational Structure, in case they do not have to propose it
3. Are there cost specialists? If not, who carries this information.
4. What primary information is considered for working with costs and expense budgets?
5. Are the costs classified? How?
6. Do you prepare an activity budget? Specify how it is structured.
7. They carry out some analysis with the information of costs and expenses that they obtain. Argue and show through an example.
8. You can consider in the work other studied aspects that are treated in the institution under study.
The exercise will be discussed in plenary session in the classroom and will be subsequently evaluated, also considering the rest of the evaluations carried out during the course of the subject.
The work must include, presentation, introduction, development, conclusions, recommendations and annexes (if required). The length of the work must be at least 10 pages, the letter to be used must be Arial 12 with 1.5 cm line spacing.
1. Ministry of Higher Education. Republic of Cuba. Teaching and methodological work regulations. Resolution No. 210/2007. Chapter II. Article 70
2. Ministry of Public Health. Finance and Accounting Department. Manual of Instructions and Procedures of Health Costs. 2009.
