Background: Hospitals increasingly need, besides effectiveness data, a
ccurate and reliable cost data to allocate their resources as efficien
tly as possible. In this article, a framework to calculate the hospita
l casts of setting up a new activity is presented and applied to pedia
tric endoscopy. Methods: The cost calculations were based on a detaile
d registration of labor time, materials, space, and equipment needed t
o perform endoscopy in pediatric patients in a tertiary care hospital,
the University Hospital in Leuven, Belgium. Results: The initial inve
stment expenses amount to 70,000 ECU ($91,000 in U.S. money), assuming
that the facilities of the adult endoscopy unit can be shared. The ad
ditional variable cost for each procedure, including labor time and ma
terials, varies between 100 and about 170 ECU ($130 and $221 U.S.), de
pending on the type of endoscopy (upper or lower, diagnostic or therap
eutic). These basic data can be used to calculate the total costs for
pediatric endoscopy under alternative scenarios (e.g., varying total n
umber of procedures). Conclusions: The costing exercise has given the
hospital better insights into the working procedures (and hence costs)
of pediatric endoscopy. Other organizations will be able to apply thi
s framework in their setting, since all included cost components, as w
ell as volumes and unit prices, are reported separately.