Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing

Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M.; Libby, Bruce; Lash, Donna H.; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N.

doi:10.1016/j.ijrobp.2017.09.004

Cited by 69 publications

(41 citation statements)

References 23 publications

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“…Brachytherapy accounts for 75% of the total radiotherapy treatment costs and 80% of the radiation oncologist's time. In addition, brachytherapy results in less revenue generation and is thus potentially associated with a net loss for the institution as well as the physician [65]. Similar trends in financial reimbursements are observed in governmentsupported schemes within private hospitals in India, wherein the use of brachytherapy is associated with a financial loss to the provider institution [33].…”

Section: Access To Brachytherapy For Cervical Cancermentioning

confidence: 90%

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

et al. 2019

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Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and lowemiddle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and lowemiddle income countries. There is an urgent need to improve treatment availability and develop better treatments. Worldwide trends, however, reveal a low number of therapeutic and innovative research trials in cervical cancer. The present article elucidates the existing challenges and provides solutions to improve outcomes. The proposed strategies hinge on strengthening collaborations for global advocacy.

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Section: Access To Brachytherapy For Cervical Cancermentioning

confidence: 90%

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

et al. 2019

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Section: Discussionmentioning

confidence: 99%

“…Recently, Bauer-Nilsen and their colleagues reported the costs of administering brachytherapy and EBRT using a time-driven activity-based costing methodology [ 20 ]. They compared the costs with the United States Medicare reimbursement and relative value units (RVUs) [ 20 ]. They demonstrated that brachytherapy is costlier to deliver and requires more time from the attending radiation oncologist and medical physicist compared with EBRT, and their analyses of the reimbursement indicated the payments to physicians do not account for the substantial time requirements and expertise in the USA [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…They compared the costs with the United States Medicare reimbursement and relative value units (RVUs) [ 20 ]. They demonstrated that brachytherapy is costlier to deliver and requires more time from the attending radiation oncologist and medical physicist compared with EBRT, and their analyses of the reimbursement indicated the payments to physicians do not account for the substantial time requirements and expertise in the USA [ 20 ]. In our present analyses, actual costs and reimbursement in yen and/or US dollars were not estimated.…”

Section: Discussionmentioning

confidence: 99%

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National survey of intracavitary brachytherapy for intact uterine cervical cancer in Japan

Toita

Ohno

Ikushima

et al. 2018

Journal of Radiation Research

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To review the current status of, and labor expended for (in terms of time required), intracavitary brachytherapy (ICBT) in definitive radiotherapy/chemoradiotherapy for cervical cancer patients, two national surveys were performed. The first survey was conducted between July and August 2016 and consisted of a questionnaire of 12 items regarding ICBT procedures for cervical cancer, which was sent to 173 centers installed with high-dose-rate remote after-loading brachytherapy systems. Between November and December 2016, another survey was performed in 79 centers to evaluate labor required for ICBT procedures in terms of time spent and number of staff involved. In the first survey, the response rate was 77% of the 173 centers. ICBT was performed for cervical cancer in 118 (89%) centers. Imaging modalities used after applicator insertion were X-ray alone in 46 (40%), computed tomography in 69 (60%) and magnetic resonance imaging in 5 (4%) centers. Three-dimensional (3D) planning was performed in 55 centers (48%). Fifty-five (70%) centers responded to the second survey regarding ICBT-mandated labor. The median cumulative duration of the entire ICBT procedure was 330 min (the sum of the times spent by each staff member) and was longer in the 3D image–guided brachytherapy (3D-IGBT) (405 min) than in the X-ray group (230 min). This trend was significant for the specific processes of image acquisition and treatment planning, especially for radiation oncologists. In definitive radiotherapy/chemoradiotherapy for cervical cancer patients, 3D-IGBT use has been gradually spreading in Japan. The present survey revealed that ICBT, especially 3D-IGBT, requires substantial labor and time from staff.

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“…In addition, TDABC is a bottom-up approach that determines cost by estimating the cost of each resource and the time each resource is used during each activity involved over the full course of treatment. This allows for better and more transparent estimates of the expenses incurred by providers in providing treatment [33]. This costing method also is commonly used in manufacturing and other service industries to assign costs accurately [34] because it provides a granular view of costs which directly reflect resource use and duration, thus providing actionable cost data to improve particular processes [35].…”

Section: Introductionmentioning

confidence: 99%

Comparative Study: Activity Based Costing and Time Driven Activity Based Costing in Electronic Industry

Zamrud¹,

Abu²

2020

JMMST

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By the 1980s, Traditional Cost Accounting (TCA) is no longer reflecting the current economic reality due to distorted information about the profitability of their orders, products, and customers. In addition, Activity-based Costing (ABC) is a costing method originally developed to overcome the shortcoming of TCA method in the era of rapidly increasing product complexity and diversification. However, it is not universally accepted because it ignores the potential for unused capacity which will be beneficial for forecasting. The objective of this work is to compare the advantages of ABC and Time-driven Activity-Based Costing (TDABC) by analyzing the features towards costing sustainment. The work begins by collecting data at electric electronic industry located at Pahang and the product selected is a magnetic inductor. ABC focuses on the costs inherent in the activity based products to produce, distribute or support the products concerned. TDABC uses time equation and capacity cost rate (CCR) to measure the unused capacity with respect to the time and cost. This work has successfully compares the methodology between ABC and TDABC in electronic industry. The item such as stages for cost allocation, determination of drivers, action taken for an additional activity, cost consideration for implementation, system building, system update, information given from each method, transparency, overestimation of cost, differentiation of service level, oversimplification of activities and capacity forecast and planning. It concludes that both have their strength according to the industry needs.

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Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing

Cited by 69 publications

References 23 publications

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

National survey of intracavitary brachytherapy for intact uterine cervical cancer in Japan

Comparative Study: Activity Based Costing and Time Driven Activity Based Costing in Electronic Industry

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