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Health System Perspective on Cost for Delivering a Decision Aid for Prostate Cancer Using Time-driven Activity-based

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Area of Science:

Health economics
Decision science
Health services research

Background:

Previsit decision aids (DAs) show promise for improving patient decision quality.
The cost of deploying DAs is not well-defined, hindering health system adoption.

Purpose of the Study:

To determine the health system cost of delivering decision aids (DAs).

Main Methods:

Observational cohort study at three institutions.
Process mapping and time-driven activity-based costing for DA delivery.
Measurement of clinic visit length and decisional quality.

Main Results:

Average costs per patient ranged from $38.32 to $59.96.
Labor constituted the largest cost component.
Electronic health record (EHR) integration demonstrated cost efficiency and reduced clinic visit times.

Conclusions:

Time-driven activity-based costing effectively identifies service delivery costs and cost-containment opportunities.
The cost of DA delivery is significantly lower than treatment costs for prostate cancer.
EHR integration enhances DA delivery efficiency and yields substantial cost savings.