Effective resource utilization in the healthcare sector: An application of material flow cost accounting and the sustainable balanced scorecard

Increasing cost pressures in healthcare services have heightened the need for innovative strategic cost management approaches, including improved resource utilization and the reduction of waste-related expenses. In this context, this study aims to implement Material Flow Cost Accounting (MFCA) and the Sustainable Balanced Scorecard (SBSC) methods within the operational processes of a biochemical laboratory. Within the scope of the study, based on 603,835 samples related to the biochemistry laboratory for the year 2023, a total of 3,617,294 test data were used, and material, energy, system, and waste costs were analyzed in detail. Three different scenarios (Assumption I, II, III) regarding material usage were developed, and in line with these scenarios, test repetitions, material losses, waste generation, and cost distributions were compared. As a result of the implementation; it was determined that there was a 20-25% reduction in material waste, up to 75% decrease in waste amount, 25% reduction in test repetitions, 23% reduction in carbon footprint, and a total cost saving of 6.1 million TL was achieved. In addition, cost management results were evaluated with the SBSC performance measurement tool in financial, customer, internal process, learning-development, environmental, and social dimensions; positive outcomes such as increased patient satisfaction, reduction in occupational accidents, and improvement in service durations were obtained. As a result of the study, it was revealed that the joint implementation of the MFCA and SBSC methods offers a strong management model for achieving cost-effectiveness, operational efficiency, and sustainability goals in healthcare services. It is suggested that this model is not limited only to biochemistry laboratories but is also applicable to other healthcare service units. The study is considered to contribute to practice in terms of monitoring costs, making losses and wastes visible, creating a comprehensive evaluation model that includes factors such as operational efficiency and patient satisfaction in addition to financial elements, and thus supporting managerial decisions for budgeting, performance measurement, and strategic planning. In addition, the study may also contribute to the scientific field in terms of being specific to the healthcare sector and including detailed literature reflecting the current situation. Future studies focusing on data standardization and automation integration will form the basis for sustainable cost management models specific to the healthcare sector.