دورية أكاديمية
أعرض في EDS

A comparative study using time-driven activity-based costing in single-fraction breast high-dose rate brachytherapy: An integrated brachytherapy suite vs. decentralized workflow.

التفاصيل البيبلوغرافية
العنوان: A comparative study using time-driven activity-based costing in single-fraction breast high-dose rate brachytherapy: An integrated brachytherapy suite vs. decentralized workflow.
المؤلفون: Squeo GC; Division of Breast and Melanoma Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA., Lattimore CM; Division of Breast and Melanoma Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA., Simone NL; Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA., Suralik G; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA., Dutta SW; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA., Schad MD; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA., Su L; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA., Libby B; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA., Janowski EM; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA., Showalter SL; Division of Breast and Melanoma Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA., Lobo JM; Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA., Showalter TN; Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA. Electronic address: tns3b@virginia.edu.
المصدر: Brachytherapy [Brachytherapy] 2022 May-Jun; Vol. 21 (3), pp. 334-340. Date of Electronic Publication: 2022 Feb 04.
نوع المنشور: Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Elsevier, 2002- Country of Publication: United States NLM ID: 101137600 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1449 (Electronic) Linking ISSN: 15384721 NLM ISO Abbreviation: Brachytherapy Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Elsevier, 2002-
مواضيع طبية MeSH: Brachytherapy*/methods , Breast Neoplasms*/radiotherapy , Breast Neoplasms*/surgery, Female ; Humans ; Mastectomy, Segmental ; Workflow
مستخلص: Introduction: Precision breast intraoperative radiation therapy (PB-IORT) is a novel approach to adjuvant radiation therapy for early-stage breast cancer performed as part of a phase II clinical trial at two institutions. One institution performs the entire procedure in an integrated brachytherapy suite which contains a CT-on-rails imaging unit and full anesthesia capabilities. At the other, breast conserving surgery and radiation therapy take place in two separate locations. Here, we utilize time-driven activity-based costing (TDABC) to compare these two models for the delivery of PB-IORT.
Methods: Process maps were created to describe each step required to deliver PB-IORT at each institution, including personnel, equipment, and supplies. Time investment was estimated for each step. The capacity cost rate was determined for each resource, and total costs of care were then calculated by multiplying the capacity cost rates by the time estimate for the process step and adding any additional product costs.
Results: PB-IORT costs less to deliver at a distributed facility, as is more commonly available, than an integrated brachytherapy suite ($3,262.22 vs. $3,996.01). The largest source of costs in both settings ($2,400) was consumable supplies, including the brachytherapy balloon applicator. The difference in costs for the two facility types was driven by personnel costs ($1,263.41 vs. $764.89). In the integrated facility, increased time required by radiation oncology nursing and the anesthesia attending translated to the greatest increases in cost. Equipment costs were also slightly higher in the integrated suite setting ($332.60 vs. $97.33).
Conclusions: The overall cost of care is higher when utilizing an integrated brachytherapy suite to deliver PB-IORT. This was primarily driven by additional personnel costs from nursing and anesthesia, although the greatest cost of delivery in both settings was the disposable brachytherapy applicator. These differences in cost must be balanced against the potential impact on patient experience with these approaches.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: P30 CA044579 United States CA NCI NIH HHS; R01 CA214594 United States CA NCI NIH HHS; T32 CA163177 United States CA NCI NIH HHS
فهرسة مساهمة: Keywords: Breast cancer; Ct-on-rails; High dose-rate brachytherapy; Integrated brachytherapy suite; Intraoperative radiation therapy; Time-driven activity-based costing
تواريخ الأحداث: Date Created: 20220207 Date Completed: 20220531 Latest Revision: 20240214
رمز التحديث: 20240214
مُعرف محوري في PubMed: PMC9149052
DOI: 10.1016/j.brachy.2021.12.006
PMID: 35125328
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-1449
DOI:10.1016/j.brachy.2021.12.006