• Brian J Yun, Anand M Prabhakar, Jonathan Warsh, Robert Kaplan, John Brennan, Kyle E Dempsey, and Ali S Raja.
• Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: byun@partners.org.
• Ann Emerg Med. 2016 Jun 1; 67 (6): 765-772.

AbstractValue in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED.Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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