دورية أكاديمية
Time-Driven Activity-Based Costing in Interventional Oncology: Cost Measurement and Cost Variability for Hepatocellular Carcinoma Therapies.
| العنوان: | Time-Driven Activity-Based Costing in Interventional Oncology: Cost Measurement and Cost Variability for Hepatocellular Carcinoma Therapies. |
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| المؤلفون: | Ljuboja D; Harvard Medical School, Boston, Massachusetts; Harvard Business School, Boston, Massachusetts; Department of Radiology, Division of Vascular and Interventional Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts; Newton-Wellesley Hospital, Newton, Massachusetts. Electronic address: damir_ljuboja@alumni.harvard.edu., Ahmed M; Chief, Division of Vascular and Interventional Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts., Ali A; Department of Radiology, Division of Vascular and Interventional Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts., Perez E; Harvard School of Public Health, Boston, Massachusetts., Subrize MW; Department of Radiology, Division of Vascular and Interventional Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts., Kaplan RS; Senior Fellow and Marvin Bower Professor of Leadership Development, Emeritus at the Harvard Business School, Boston, Massachusetts., Sarwar A; Co-Director Liver Tumor Program, Division of Vascular and Interventional Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts. |
| المصدر: | Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2021 Aug; Vol. 18 (8), pp. 1095-1105. Date of Electronic Publication: 2021 Apr 30. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101190326 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1558-349X (Electronic) Linking ISSN: 15461440 NLM ISO Abbreviation: J Am Coll Radiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Elsevier, c2004- |
| مواضيع طبية MeSH: | Carcinoma, Hepatocellular*/therapy , Chemoembolization, Therapeutic* , Liver Neoplasms*/therapy, Humans ; Prospective Studies ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Purpose: To use time-drive activity-based costing (TDABC) to characterize and compare costs of transarterial chemoembolization (TACE), transarterial radioembolization (TARE), and ablation. Methods: This three-part study involved (1) prospective observation to record resources used during TACE, TARE, and ablation and statistical evaluation of interobserver and interprocedure variability; (2) Bland-Altman analysis of prospective measurements and medical record time stamps to establish practicality of using retrospective data in place of direct observation; (3) retrospective time stamp assessment for 117 ablations, 61 TACE procedures, and 61 TARE procedures to reveal variability drivers. Results: Ablation costs were lowest ($3,744), which were 74% of TACE costs ($5,089) and 18% of TARE costs ($20,818). Consumables were the greatest cost contributor, accounting for 65% of ablation, 58% of TACE, and 90% of TARE costs. A single consumable contributed to most of the overall costs: the ablation probe (42%), ethiodized oil for TACE (30%), and yttrium-90 microspheres for TARE (80%). Bland-Altman analysis showed agreement between retrospective time stamps and prospective measurements. Ablation costs increased from $3,288 to $4,245 to $4,461 for one, two, or three tumors treated. TACE cost increased from $5,051 to $5,296 for lobar versus selective approaches. Conclusion: A bottom-up costing approach using TDABC is feasible to assess true costs of hepatocellular carcinoma treatments and demonstrates ablation costs are significantly less than those of TACE and TARE. Replication of these methods at other institutions can facilitate development of a bundled payment model to promote utilization of locoregional therapies for hepatocellular carcinoma. (Copyright © 2021 American College of Radiology. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Ablation; TACE; cost analysis; interventional radiology; time-driven activity-based costing (TDABC) |
| تواريخ الأحداث: | Date Created: 20210503 Date Completed: 20210818 Latest Revision: 20210818 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jacr.2021.03.027 |
| PMID: | 33939974 |
| قاعدة البيانات: | MEDLINE |
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