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Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
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Time-Driven Activity Based Costing of an Annual Canadian Cochlear Implant Program.

Alice Q Liu1, Sonya Allenby2, Jowan Lee3

  • 1Division of Otolaryngology-Head and Neck Surgery, University of British Columbia, Vancouver, Canada.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 23, 2024
PubMed
Summary

The annual cost to run an adult cochlear implant (CI) program in Canada is approximately $4.54 million, with the CI device being the largest single expense. This study provides crucial data for healthcare budgeting and resource allocation for CI services.

Keywords:
cochlear implantcostotolaryngologytime‐driven activity based costingvaluevalue‐based health care

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Area of Science:

  • Health Economics
  • Otolaryngology
  • Medical Technology Assessment

Background:

  • Cochlear implant (CI) programs are essential for individuals with severe to profound hearing loss.
  • Accurate cost assessment is vital for sustainable healthcare program management.
  • Previous cost analyses for CI programs are limited, particularly from a Canadian provincial perspective.

Purpose of the Study:

  • To determine the comprehensive annual cost of operating an adult cochlear implant program.
  • To analyze costs associated with patient assessment, implantation, and follow-up.
  • To provide a Canadian provincial government perspective on CI program expenditures.

Main Methods:

  • Utilized Time-Driven Activity-Based Costing (TDABC) to model the CI program.
  • Developed and validated clinical scenario pathways with stakeholders.
  • Calculated costs based on all patients referred in 2019, with figures updated to 2023 Canadian dollars.

Main Results:

  • The total annual cost for the CI program in 2019 was $4.542 million CAD ($3.365 million USD).
  • The cost per implanted patient was $29,511 CAD ($21,865 USD).
  • The cochlear implant device represented the highest single cost, followed by surgical and switch-on day expenses, and audiological assessments; labor costs were significant across other steps.

Conclusions:

  • The TDABC model provides a detailed cost breakdown for adult CI programs.
  • The total annual cost for managing all referrals was substantial, highlighting the financial commitment required.
  • The high cost of the CI device itself is a primary driver of overall program expenditure.