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A Bootstrap Method to Estimate Cost of Behavioral Intervention Implementation: A Proof of Concept
Julia Mo1, Daniel Maeng2, Mark C Hornbrook3
1Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA.
Objective:
To develop a bootstrapping method to augment time-driven activity-based costing (TDABC) analysis intended to allow more realistic cost estimates.
Data Sources:
Secondary data from a multisite clinical trial conducted from 2016 to 2018 on an ostomy self-management telehealth intervention for cancer survivors.
Study Design:
The intervention cost was newly estimated by incorporating expected patient participation rates calculated via bootstrapping. This cost was compared against the cost estimate obtained via traditional TDABC.
Data Collection:
Study personnel self-reported the time spent on each activity associated with the intervention. We also utilized patient participation data collected from the trial.
Principal Findings:
The total cost of the telehealth intervention estimated via the bootstrapping method was $210,052.62 (95% CI: 208,652.13, 211,402.51), with an average cost per participant of $1981.63 (95% CI: 1968.42, 1994.36). Traditional TDABC analysis yielded $186,363 or $1758 per participant. Further adjusting assumptions about the cost of the postintervention monitoring phase, our approach yielded an alternative estimate of $176,362.56 (95% CI: 174,962.07, 177,712.45) and an average cost per participant of $1663.80 (95% CI: 1650.59, 1676.53) suggesting both methods yielded similar bottom-line results.
Conclusions:
Incorporating bootstrapping into traditional TDABC methodology is feasible and is likely to capture variance in clinical trial data.
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