Time-Driven Activity-Based Costing for Capturing the Complexity of Healthcare Processes: The Case of Deep Vein Thrombosis and Leg Ulcers
| Autor: | Carla Rognoni, Alessandro Furnari, Marzia Lugli, Oscar Maleti, Alessandro Greco, Rosanna Tarricone |
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| Rok vydání: | 2023 |
| Předmět: |
STANDARD MEDICAL TREATMENT
COMPRESSION THERAPY VENOUS STENTING DEEP VENOUS OUTFLOW OBSTRUCTION LEG ULCERS Health Toxicology and Mutagenesis TIME DRIVEN ACTIVITY-BASED COSTING venous stenting standard medical treatment compression therapy deep venous outflow obstruction leg ulcers cost-utility analysis time driven activity-based costing VENOUS STENTING STANDARD MEDICAL TREATMENT COMPRESSION THERAPY DEEP VENOUS OUTFLOW OBSTRUCTION LEG ULCERS COST-UTILITY ANALYSIS TIME DRIVEN ACTIVITY-BASED COSTING Public Health Environmental and Occupational Health COST-UTILITY ANALYSIS |
| Zdroj: | International Journal of Environmental Research and Public Health; Volume 20; Issue 10; Pages: 5817 |
| ISSN: | 1660-4601 |
| DOI: | 10.3390/ijerph20105817 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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