Cargando…

Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers

Time-driven activity-based costing (TDABC) is suggested to assess costs within the value-based healthcare approach, but there is a paucity of applications in chronic diseases such as deep vein thrombosis (DVT) and leg ulcers. In this context, we applied TDABC in a cost-effectiveness analysis compari...

Descripción completa

Detalles Bibliográficos
Autores principales: Rognoni, Carla, Furnari, Alessandro, Lugli, Marzia, Maleti, Oscar, Greco, Alessandro, Tarricone, Rosanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218671/
https://www.ncbi.nlm.nih.gov/pubmed/37239543
http://dx.doi.org/10.3390/ijerph20105817
_version_ 1785048828860170240
author Rognoni, Carla
Furnari, Alessandro
Lugli, Marzia
Maleti, Oscar
Greco, Alessandro
Tarricone, Rosanna
author_facet Rognoni, Carla
Furnari, Alessandro
Lugli, Marzia
Maleti, Oscar
Greco, Alessandro
Tarricone, Rosanna
author_sort Rognoni, Carla
collection PubMed
description Time-driven activity-based costing (TDABC) is suggested to assess costs within the value-based healthcare approach, but there is a paucity of applications in chronic diseases such as deep vein thrombosis (DVT) and leg ulcers. In this context, we applied TDABC in a cost-effectiveness analysis comparing venous stenting to compression ± anticoagulation (standard of care—SOC) from both hospital and societal perspectives in Italy. TDABC was applied to both treatments to assess costs that were included in a cost-effectiveness model. Clinical inputs were retrieved from the literature and integrated with real-world data. The Incremental Cost Utility Ratio (ICUR) of stenting compared to SOC was EUR 10,270/QALY and EUR 8962/QALY for hospital and societal perspectives, respectively. The mean cost per patient for venous stenting of EUR 5082 was higher than the Diagnosis-Related Group (DRG) reimbursement (EUR 4742). For SOC, an ulcer healing in 3 months costs EUR 1892, of which EUR 302 (16%) is borne by the patient versus a reimbursement of EUR 1132. TDABC showed that venous stenting may be cost-effective compared with SOC but that reimbursement rates may not completely cover the real costs, which are partially sustained by the patients. A more efficient policy for covering the real costs may be beneficial for both clinical centers and patients.
format Online
Article
Text
id pubmed-10218671
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-102186712023-05-27 Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers Rognoni, Carla Furnari, Alessandro Lugli, Marzia Maleti, Oscar Greco, Alessandro Tarricone, Rosanna Int J Environ Res Public Health Article Time-driven activity-based costing (TDABC) is suggested to assess costs within the value-based healthcare approach, but there is a paucity of applications in chronic diseases such as deep vein thrombosis (DVT) and leg ulcers. In this context, we applied TDABC in a cost-effectiveness analysis comparing venous stenting to compression ± anticoagulation (standard of care—SOC) from both hospital and societal perspectives in Italy. TDABC was applied to both treatments to assess costs that were included in a cost-effectiveness model. Clinical inputs were retrieved from the literature and integrated with real-world data. The Incremental Cost Utility Ratio (ICUR) of stenting compared to SOC was EUR 10,270/QALY and EUR 8962/QALY for hospital and societal perspectives, respectively. The mean cost per patient for venous stenting of EUR 5082 was higher than the Diagnosis-Related Group (DRG) reimbursement (EUR 4742). For SOC, an ulcer healing in 3 months costs EUR 1892, of which EUR 302 (16%) is borne by the patient versus a reimbursement of EUR 1132. TDABC showed that venous stenting may be cost-effective compared with SOC but that reimbursement rates may not completely cover the real costs, which are partially sustained by the patients. A more efficient policy for covering the real costs may be beneficial for both clinical centers and patients. MDPI 2023-05-13 /pmc/articles/PMC10218671/ /pubmed/37239543 http://dx.doi.org/10.3390/ijerph20105817 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rognoni, Carla
Furnari, Alessandro
Lugli, Marzia
Maleti, Oscar
Greco, Alessandro
Tarricone, Rosanna
Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers
title Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers
title_full Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers
title_fullStr Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers
title_full_unstemmed Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers
title_short Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers
title_sort time-driven activity-based costing for capturing the complexity of healthcare processes: the case of deep vein thrombosis and leg ulcers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218671/
https://www.ncbi.nlm.nih.gov/pubmed/37239543
http://dx.doi.org/10.3390/ijerph20105817
work_keys_str_mv AT rognonicarla timedrivenactivitybasedcostingforcapturingthecomplexityofhealthcareprocessesthecaseofdeepveinthrombosisandlegulcers
AT furnarialessandro timedrivenactivitybasedcostingforcapturingthecomplexityofhealthcareprocessesthecaseofdeepveinthrombosisandlegulcers
AT luglimarzia timedrivenactivitybasedcostingforcapturingthecomplexityofhealthcareprocessesthecaseofdeepveinthrombosisandlegulcers
AT maletioscar timedrivenactivitybasedcostingforcapturingthecomplexityofhealthcareprocessesthecaseofdeepveinthrombosisandlegulcers
AT grecoalessandro timedrivenactivitybasedcostingforcapturingthecomplexityofhealthcareprocessesthecaseofdeepveinthrombosisandlegulcers
AT tarriconerosanna timedrivenactivitybasedcostingforcapturingthecomplexityofhealthcareprocessesthecaseofdeepveinthrombosisandlegulcers