Strategic Cost Management in Light of the Lean Paradigm: A Public Hospital Case Study

YALIN PARADİGMA IŞIĞINDA STRATEJİK MALİYET YÖNETİMİ: BİR KAMU HASTANESİ ÇALIŞMASI

Abstract

Aim: This study aims to propose an integrated approach to cost management in Turkish public hospitals. The research develops a model that measures costs via Target Costing and seeks to achieve these targets through Lean Healthcare principles as an operational improvement tool.

Material and Method: In this mixed-methods research, the qualitative phase employed participatory action research, observation, process mapping, and content analysis. The quantitative phase reached the target cost index by evaluating survey data, cost accounting, and content analysis findings. Lean techniques were applied to eliminate identified cost gaps and wastes.

Results: Target Costing analysis revealed that examination and treatment services had low costs relative to patient-perceived value, whereas laboratory tests, imaging, and medical supplies incurred high costs. Revenue from cholecystectomy surgeries covered only 44% of service costs. Lean integration showed an improvement potential of 14% in emergency department waiting times and 33% in outpatient clinics.

Conclusion: The study demonstrates that an integrated model advocating strategic cost management through operational transformation—rather than mere measurement—can provide cost-effectiveness and measurable improvements in public healthcare services.