Time-Driven Activity-Based Costing in Breast Cancer Care Delivery

Area of Science:

• Oncology
• Health Economics
• Healthcare Management

Background:

• Accurate measurement of healthcare costs is crucial for assessing and enhancing the value of oncology care.
• Understanding cost drivers in cancer care delivery is essential for optimizing resource allocation and improving patient outcomes.

Purpose of the Study:

• To determine the comprehensive cost of breast cancer care provision across multiple healthcare organizations.
• To identify key factors influencing the total cost of breast cancer treatment pathways.

Main Methods:

• Employed time-driven activity-based costing (TDABC) to calculate the full cost of breast cancer care.
• Developed process maps, determined capacity cost rates, and measured process times using clinic observation and Real-Time Location System (RTLS) data.
• Included costs for initial planning, chemotherapy, radiation, surgery, reconstruction, and ancillary services.

Main Results:

• Surgical costs varied from $1,431 (lumpectomy) to $12,129 (mastectomy with reconstruction).
• Radiation therapy cost $1,224 for simulation and $200 per additional treatment; chemotherapy delivery averaged $382 per visit, plus agent costs.
• Personnel expenses were the primary cost driver in surgery, except for mastectomy with reconstruction, where device costs reached 60%.

Conclusions:

• The total cost of breast cancer care is influenced by treatment protocols, patient reconstruction choices, and the necessity of ancillary services.
• Identifying actual costs and cost drivers can inform better resource utilization, potentially lowering costs and enhancing care quality.
• This study provides a framework for detailed cost analysis in oncology care delivery.