AviCenna VKBS
The national case-mix platform behind Türkiye's first DRG cost weights — comparison, planning and management from a single clinical dataset.
AviCenna VKBS turns the clinical record of a health system into costed fact: what a case actually costs, how one hospital compares with another, and where the next budget should go. It carries the Australian coding standards, a rule engine that checks its own output before anything becomes a cost weight, and clinical cost accounting underneath. It produced the first case costs ever calculated for the Turkish health system, and has processed more than 1.9 million clinical cases since.
- Web-based, centrally managed architecture
- Comprehensive clinical dataset spanning the national hospital network
- Clinical costing built on a cost-accounting method
- Budget simulation and scenario modelling
- Multi-dimensional reporting and statistics
- Automated quality checks and sequencing logic across complex pathways
- Benchmarking across departments, hospitals, regions and countries
- Integration with hospital information systems already in service
A case-mix system is really three questions
How does this hospital compare, what will next year cost, and is the money buying good care? Everything else the system does is in service of answering those three.
Comparison
- International hospitals
- Public hospitals
- University and private hospitals
- Departments within a hospital
Planning
- Resource planning
- National budget
- Hospital budget
- Investment decisions
Management
- Health indicators
- Technical efficiency
- Clinical performance
- Cost effectiveness
Built over a decade, not a procurement cycle
National costing systems are slow work. Turkey's took eight years to reach its first set of cost weights, and we were there for all of it.
- 2004
First analysis
The initial feasibility and preparation work, at a point when most of Europe was still deciding whether to adopt case-mix funding at all.
- 2009
The clinical picture
Clinical data gathered from more than 500 Ministry of Health hospitals, and the diagnosis-related groups themselves constructed from it.
- 2012
The first cost weights
Clinical and financial data from 81 Ministry of Health hospitals, producing the first case costs ever calculated for the Turkish health system — our own work.
Costed from the ledger, not estimated
A case-mix system is only as trustworthy as the money underneath it. VKBS is built on cost accounting rather than averages, so a cost weight can be traced back to the clinical activity and the ledger entry that produced it.
- Clinical costing derived from hospital cost accounting
- Budget simulation before decisions are committed
- Reporting across any combination of hospital, unit, period and case type
What a health system gains
Most of the value in adopting an established national platform is the years you do not spend building one.
- Standards, groupers and cost models already in place
- A decade of national implementation behind the method
- Central management, with room for local variation
- Decision support for ministries, regions and individual hospitals
- Integration paths into systems already running
One loop, two directions
Clinical and cost data rises from the hospitals; comparison, pricing and budgeting come back down from the payers. VKBS is the platform in the middle that makes both directions mean the same thing.
- DRG
- Cost Weight
- Budget Allocation
- Coding Quality
- Case-Mix
- Cost Accounting
- Budget Modelling
- Comparison
- Pricing
- Budgeting
- Clinical costing
- Clinical data
- Cost data
From the cost centre to the patient
Hospital expenses are booked to cost centres — departments, wards, support units. Management asks its questions at patient level: what does one admission actually cost, which DRG group is the most expensive, what does a complete treatment episode consume, and are two of our hospitals producing the same case at different cost? The Costing Tool is the next generation of the VKBS costing engine: it pushes cost-centre expense down to the individual patient through traceable stages, and proves conservation of money at every step.
Three methods, one platform
Activity-based (ABC), DRG-based and episode-based costing run on the same data set — no separate models to reconcile.
Configurable allocation engine
D0–D6 allocation stages, configurable per facility, step-down or reciprocal. Every step can be previewed, run, approved or rolled back.
Hybrid case costing
Activity-based where resource recipes exist, top-down cluster rules where they don't — both methods can apply within the same case.
Integration or manual entry
Every data set can be pulled from the HIS or ERP by business codes, or entered on screen through an Excel-like cost and driver grid.
Built for hospital groups
Facility-scoped authorisation, a working-facility switch, and a comparison screen placing facilities and periods side by side with Δ%.
Multilingual, right-to-left ready
Not only the labels: definition names, rule names and engine messages are translated too, including right-to-left layouts.
From cost centre to patient — five traceable stages
One rule holds across all five: what goes in equals what comes out.
- D0
Loading
Expense type × cost centre matrix, with optional admission-type split and pooled invoices.
- D1–D6
Allocation
Closed units distributed to open units by drivers: m², kWh, bed-days, visits.
- Stage 3
Activity cost
Pools split into activities by resource-usage recipe and volume — a unit cost per activity.
- Stage 4
Case cost
Activities consumed × unit cost, plus cluster rules for units without recipes.
- Stage 5
DRG & episode
Trimmed means, relative weights, case-mix index, and episodes across periods.
The amount loaded equals the amount distributed to patients, and every unit of currency stays traceable back to the ledger entry it came from. Each allocation step can be previewed, run, approved or rolled back, and the result is recorded in a ledger.
Real unit cost per activity
Activities are defined per department — triage, sampling, analysis, imaging, an ICU day, an operation. Resource-usage recipes state which pool feeds which activity and in what proportion: radiology depreciation reaches only the scans that use the device, and the physician pool reaches reporting by minute weighting.
Weights against a national reference
Diagnosis (ICD-10), procedure and DRG codes come from the HIS or are entered manually. For each DRG the platform gives case count, IQR-trimmed mean cost, bounds, the hospital's relative weight and its gap to the national reference, average length of stay and cost profile.
Cost of a full treatment pathway
Episodes are defined by a trigger DRG and a window — sepsis 30 days, cholecystectomy 90-day bundle, stroke 90 days. Triggering admissions become episodes automatically and follow-up visits inside the window are attached; episode cost accumulates across periods.
One screen for all three views
Every data set, from the HIS or by hand
Every data set can be received from an external system and entered on screen. The endpoint works with business codes: records are created if absent and updated if present, with a line-by-line error report.
| Data set | Source system | Content |
|---|---|---|
| Cost matrix (D0) | ERP / accounting | Period, cost centre, expense type, amount, admission type, pooled flag |
| Driver values | Technical / HR / HIS | m², kWh, headcount, bed-days, visit counts |
| Cases | HIS | Case number, patient, department, admission type, dates, DRG code |
| Case activities | HIS orders / procedures | Case number, activity code, quantity |
| Case statistics | HIS | Bed-days, ICU days, drug amounts (for the cluster method) |
| Diagnoses & procedures | HIS | ICD-10 and procedure codes |
| Episodes | HIS / manual | Episode code, patient, linked cases |
Key screens
- Dashboard — live data from all three engines
- Cost & driver entry — Excel-like D0 matrix with paste support
- Allocation engine — step cards, matrix, ledger
- Activity cost & volumes — pool to activity unit costs
- Case cost — activity and cluster breakdown per case
- DRG weights & episodes — trimmed means, relative weights, case-mix index
- Facility comparison — facilities and periods with Δ%
- Setup, import, administration — 40+ management screens
Technical summary
- Backend — Java 21, Spring Boot 3.2; database-independent, running on your existing RDBMS. REST API, JWT sessions, screen- and action-level role-based access control.
- Frontend — Modern web interface; runs in any current browser, with no client installation.
- Deployment — Docker (API + nginx), single server or container platform; connects to your existing database.
- Performance — Case costing for a ~450-case period in one to two seconds; result screens sub-second.
- Security — Facility-scoped row access, audit fields and a deletion trail.
Tell us what your health system needs to do
We work with ministries, hospital groups and funding agencies to scope national digital health programmes.