Quantifying costs during trauma bay resuscitation: A time-driven activity-based costing (TDABC) study

Area of Science:

• Healthcare management
• Trauma surgery
• Health economics

Background:

• Value-based care necessitates precise cost assessment.
• Time-driven activity-based costing (TDABC) is a bottom-up method for calculating service costs.
• Accurate cost data is crucial for defining the cost component of the value equation in healthcare.

Purpose of the Study:

• To apply TDABC for calculating costs of initial trauma patient resuscitation.
• To determine direct and indirect costs associated with trauma bay resuscitation.

Main Methods:

• TDABC was employed to measure costs for adult trauma patients at a Level 1 trauma center.
• The initial resuscitation phase was defined from trauma bay arrival to CT scan or OR departure.
• 360-degree video footage and institutional operating expenses (CMS data) were used to calculate per-minute personnel, supply, and indirect costs.

Main Results:

• 134 patients were analyzed (mean age 36 years, 68% male).
• Average resuscitation duration was 17 minutes.
• Average total cost per resuscitation was $3,628 ($506 direct, $3,122 indirect).

Conclusions:

• TDABC is an effective tool for costing trauma bay resuscitations.
• This methodology allows for precise financial assessment of patient care.
• It identifies opportunities for optimizing resource allocation in trauma resuscitation.