+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Time-Driven Activity-Based Costing: A Comparative Cost Analysis of Whole-Breast Radiotherapy Versus Balloon-Based Brachytherapy in the Management of Early-Stage Breast Cancer



Time-Driven Activity-Based Costing: A Comparative Cost Analysis of Whole-Breast Radiotherapy Versus Balloon-Based Brachytherapy in the Management of Early-Stage Breast Cancer



Journal of Oncology Practice 12(5): E584



Value in health care is defined as outcomes achieved per dollar spent, and understanding cost is critical to delivering high-value care. Traditional costing methods reflect charges rather than fundamental costs to provide a service. The more rigorous method of time-driven activity-based costing was used to compare cost between whole-breast radiotherapy (WBRT) and accelerated partial-breast irradiation (APBI) using balloon-based brachytherapy. For WBRT (25 fractions with five-fraction boost) and APBI (10 fractions twice daily), process maps were created outlining each activity from consultation to post-treatment follow up. Through staff interviews, time estimates were obtained for each activity. The capacity cost rates (CCR), defined as cost per minute, were calculated for personnel, equipment, and physical space. Total cost was calculated by multiplying the time required of each resource by its CCR. This was then summed and combined with cost of consumable materials. The total cost for WBRT was $5,333 and comprised 56% personnel costs and 44% space/equipment costs. For APBI, the total cost was $6,941 (30% higher than WBRT) and comprised 51% personnel costs, 6% space/equipment costs, and 43% consumable materials costs. The attending physician had the highest CCR of all personnel ($4.28/min), and APBI required 24% more attending time than WBRT. The most expensive activity for APBI was balloon placement and for WBRT was computed tomography simulation. APBI cost more than WBRT when using the dose/fractionation schemes analyzed. Future research should use time-driven activity-based costing to better understand cost with the aim of reducing expenditure and defining bundled payments.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059134890

Download citation: RISBibTeXText

PMID: 27006360

DOI: 10.1200/jop.2015.008441


Related references

Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer. Clinical Oncology ) 29(3): E57, 2017

What is the cost of delivering routine vaccinations at GP practices in England? A comparative time-driven activity-based costing analysis. Human Vaccines and Immunotherapeutics 15(12): 3016-3023, 2019

Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management. Research in Social and Administrative Pharmacy 12(3): 475-485, 2016

Comparative Analysis of Ultrahypofractionated Brachytherapy Two-Day Partial Breast Irradiation vs Hypofractionated Whole Breast External Beam Radiation for Early-Stage Breast Cancer. BrachyTherapy 15: S41-S42, 2016

Partial breast irradiation versus whole breast radiotherapy for early-stage breast cancer: a decision analysis. International Journal of Radiation Oncology Biology Physics 70(2): 469-476, 2008

A cost comparison analysis of partial versus whole-breast irradiation after breast-conserving surgery for early-stage breast cancer. International Journal of Radiation Oncology, Biology, Physics 62(3): 790-796, 2005

Retroperitoneal versus transperitoneal robotic-assisted laparoscopic partial nephrectomy: a matched-pair, bicenter analysis with cost comparison using time-driven activity-based costing. Current Opinion in Urology 28(2): 108-114, 2018

Activity-Based Costing and Time-Driven Activity-Based Costing for Assessing the Costs of Cancer Prevention, Diagnosis, and Treatment: A Systematic Review of the Literature. Value in Health Regional Issues 17: 142-147, 2018

Intraoperative Radiotherapy Versus Whole-Breast External Beam Radiotherapy in Early-Stage Breast Cancer: A Systematic Review and Meta-Analysis. Medicine 94(27): E1143, 2015

External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison. Journal of Contemporary BrachyTherapy 8(4): 294-300, 2016

Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing. Journal of Korean Academy of Nursing 41(4): 500-509, 2011

A comparison of quality of life for patients with early stage breast cancer treated with whole breast irradiation versus targeted partial breast brachytherapy. International Journal of Radiation Oncology Biology Physics 57(2 Suppl.): S310, 2003

The TARGIT trial: targeted intraoperative radiation therapy versus conventional postoperative whole-breast radiotherapy after breast-conserving surgery for the management of early-stage invasive breast cancer (a trial update). American Journal of Surgery 194(4): 507-510, 2007

Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing. International Journal of Radiation Oncology Biology Physics 100(1): 88-94, 2018

Quantifying institutional resource utilization of adjuvant brachytherapy and intensity-modulated radiation therapy for endometrial cancer via time-driven activity-based costing. BrachyTherapy 18(4): 445-452, 2019