Time-Driven Activity-Based Costing for Cataract Surgery in Canada: The Case of the Kensington Eye Institute

Time-driven activity-based costing (TDABC) has received considerable attention globally as a way to measure value in healthcare systems. This study aimed to apply TDABC for cataract surgery at the Kensington Eye Institute (KEI). During a field evaluation, a detailed process map was created for cataract surgery at KEI. The amount of resource use in terms of providers, equipment, space and consumables was calculated to determine the total costs of care. The average patient journey lasted 76 minutes, with 13 minutes of the surgical procedure occurring in the operating room (OR). The average procedure's cost per case was $545.28, which included consumables (34.40%), space and equipment (23.702%), personnel (11.69%), overhead (30.27%) and OR (57%). KEI cataract operation was at approximately 50% capacity due to funding limits. The TDABC process map and costing allow centres to have data-driven support tools for care redesign and optimization.