National costs and resource requirements of external beam radiotherapy: A time-driven activity-based costing model from the ESTRO-HERO project

Noemie Defourny; Lionel Perrier; Josep-Maria Borras; Mary Coffey; Julietta Corral; Sophie Hoozee; Judith van Loon; Cai Grau; Yolande Lievens

doi:10.1016/j.radonc.2019.06.015

National costs and resource requirements of external beam radiotherapy: A time-driven activity-based costing model from the ESTRO-HERO project

Noemie Defourny^*, Lionel Perrier, Josep-Maria Borras, Mary Coffey, Julietta Corral, Sophie Hoozee, Judith van Loon, Cai Grau, Yolande Lievens

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

20 Citations (Web of Science)

Abstract

Background: The Health Economics in Radiation Oncology (ESTRO-HERO) project aims to provide a knowledge base for health economics in European radiotherapy. A cost-accounting model, providing data on national resource requirements and costs of external beam radiotherapy (EBRT), was developed.

Materials and methods: Time-driven activity-based costing (TD-ABC) was applied from the healthcare provider perspective at national level. TD-ABC allocates resource costs to treatment courses through the activities performed, based on time estimates.

Results: The model is structured in three layers. The central layer, EBRT-Core, accounts for EBRT care-pathway activities and follows TD-ABC allocation principles. Activities supporting radiation oncology (RO) (RO-Support) and multidisciplinary oncology (Beyond-EBRT) follow standard allocation principles.

To demonstrate the model's capabilities, a dataset was constructed for the hypothetical country Europalia, based on published evidence on resources and treatments, whereas time estimates were expert opinions. Applying the TD-ABC model to this example, treatment delivery activities represent 68.4% of the costs; treatment preparation 31.6%. The cost per course shows large variation for different indications, techniques, and fractionation schedules, ranging between (sic)838 and (sic)7193. Resource utilization was estimated to be within the available capacity. Scenario analyses on changes in fractionation and treatment complexity are presented.

The ESTRO-HERO TD-ABC tool can model EBRT costs and resource requirements. While the Europalia example illustrates its potential, the results cannot be generalized nor used as a proxy for national evidence. Only real-world data, tailored to the specificities of individual countries, will support National Radiation Oncology Societies with investment planning and access to innovative radiotherapy. (C) 2019 Elsevier B.V. All rights reserved.

Original language	English
Pages (from-to)	187-194
Number of pages	8
Journal	Radiotherapy and Oncology
Volume	138
DOIs	https://doi.org/10.1016/j.radonc.2019.06.015
Publication status	Published - Sept 2019

Keywords

Time-driven activity-based costing
Cost analysis
Radiotherapy
Healthcare provider perspective
Hospital Financial Management
INTENSITY-MODULATED RADIOTHERAPY
EUROPEAN COUNTRIES
GUIDELINES
CANCER
DEPARTMENTS
MANAGEMENT
EQUIPMENT

Access to Document

10.1016/j.radonc.2019.06.015

Cite this

@article{e64679c2699043028f8f8138b440a3e7,

title = "National costs and resource requirements of external beam radiotherapy: A time-driven activity-based costing model from the ESTRO-HERO project",

abstract = "Background: The Health Economics in Radiation Oncology (ESTRO-HERO) project aims to provide a knowledge base for health economics in European radiotherapy. A cost-accounting model, providing data on national resource requirements and costs of external beam radiotherapy (EBRT), was developed.Materials and methods: Time-driven activity-based costing (TD-ABC) was applied from the healthcare provider perspective at national level. TD-ABC allocates resource costs to treatment courses through the activities performed, based on time estimates.Results: The model is structured in three layers. The central layer, EBRT-Core, accounts for EBRT care-pathway activities and follows TD-ABC allocation principles. Activities supporting radiation oncology (RO) (RO-Support) and multidisciplinary oncology (Beyond-EBRT) follow standard allocation principles.To demonstrate the model's capabilities, a dataset was constructed for the hypothetical country Europalia, based on published evidence on resources and treatments, whereas time estimates were expert opinions. Applying the TD-ABC model to this example, treatment delivery activities represent 68.4% of the costs; treatment preparation 31.6%. The cost per course shows large variation for different indications, techniques, and fractionation schedules, ranging between (sic)838 and (sic)7193. Resource utilization was estimated to be within the available capacity. Scenario analyses on changes in fractionation and treatment complexity are presented.The ESTRO-HERO TD-ABC tool can model EBRT costs and resource requirements. While the Europalia example illustrates its potential, the results cannot be generalized nor used as a proxy for national evidence. Only real-world data, tailored to the specificities of individual countries, will support National Radiation Oncology Societies with investment planning and access to innovative radiotherapy. (C) 2019 Elsevier B.V. All rights reserved.",

keywords = "Time-driven activity-based costing, Cost analysis, Radiotherapy, Healthcare provider perspective, Hospital Financial Management, INTENSITY-MODULATED RADIOTHERAPY, EUROPEAN COUNTRIES, GUIDELINES, CANCER, DEPARTMENTS, MANAGEMENT, EQUIPMENT",

author = "Noemie Defourny and Lionel Perrier and Josep-Maria Borras and Mary Coffey and Julietta Corral and Sophie Hoozee and {van Loon}, Judith and Cai Grau and Yolande Lievens",

year = "2019",

month = sep,

doi = "10.1016/j.radonc.2019.06.015",

language = "English",

volume = "138",

pages = "187--194",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - National costs and resource requirements of external beam radiotherapy

T2 - A time-driven activity-based costing model from the ESTRO-HERO project

AU - Defourny, Noemie

AU - Perrier, Lionel

AU - Borras, Josep-Maria

AU - Coffey, Mary

AU - Corral, Julietta

AU - Hoozee, Sophie

AU - van Loon, Judith

AU - Grau, Cai

AU - Lievens, Yolande

PY - 2019/9

Y1 - 2019/9

N2 - Background: The Health Economics in Radiation Oncology (ESTRO-HERO) project aims to provide a knowledge base for health economics in European radiotherapy. A cost-accounting model, providing data on national resource requirements and costs of external beam radiotherapy (EBRT), was developed.Materials and methods: Time-driven activity-based costing (TD-ABC) was applied from the healthcare provider perspective at national level. TD-ABC allocates resource costs to treatment courses through the activities performed, based on time estimates.Results: The model is structured in three layers. The central layer, EBRT-Core, accounts for EBRT care-pathway activities and follows TD-ABC allocation principles. Activities supporting radiation oncology (RO) (RO-Support) and multidisciplinary oncology (Beyond-EBRT) follow standard allocation principles.To demonstrate the model's capabilities, a dataset was constructed for the hypothetical country Europalia, based on published evidence on resources and treatments, whereas time estimates were expert opinions. Applying the TD-ABC model to this example, treatment delivery activities represent 68.4% of the costs; treatment preparation 31.6%. The cost per course shows large variation for different indications, techniques, and fractionation schedules, ranging between (sic)838 and (sic)7193. Resource utilization was estimated to be within the available capacity. Scenario analyses on changes in fractionation and treatment complexity are presented.The ESTRO-HERO TD-ABC tool can model EBRT costs and resource requirements. While the Europalia example illustrates its potential, the results cannot be generalized nor used as a proxy for national evidence. Only real-world data, tailored to the specificities of individual countries, will support National Radiation Oncology Societies with investment planning and access to innovative radiotherapy. (C) 2019 Elsevier B.V. All rights reserved.

AB - Background: The Health Economics in Radiation Oncology (ESTRO-HERO) project aims to provide a knowledge base for health economics in European radiotherapy. A cost-accounting model, providing data on national resource requirements and costs of external beam radiotherapy (EBRT), was developed.Materials and methods: Time-driven activity-based costing (TD-ABC) was applied from the healthcare provider perspective at national level. TD-ABC allocates resource costs to treatment courses through the activities performed, based on time estimates.Results: The model is structured in three layers. The central layer, EBRT-Core, accounts for EBRT care-pathway activities and follows TD-ABC allocation principles. Activities supporting radiation oncology (RO) (RO-Support) and multidisciplinary oncology (Beyond-EBRT) follow standard allocation principles.To demonstrate the model's capabilities, a dataset was constructed for the hypothetical country Europalia, based on published evidence on resources and treatments, whereas time estimates were expert opinions. Applying the TD-ABC model to this example, treatment delivery activities represent 68.4% of the costs; treatment preparation 31.6%. The cost per course shows large variation for different indications, techniques, and fractionation schedules, ranging between (sic)838 and (sic)7193. Resource utilization was estimated to be within the available capacity. Scenario analyses on changes in fractionation and treatment complexity are presented.The ESTRO-HERO TD-ABC tool can model EBRT costs and resource requirements. While the Europalia example illustrates its potential, the results cannot be generalized nor used as a proxy for national evidence. Only real-world data, tailored to the specificities of individual countries, will support National Radiation Oncology Societies with investment planning and access to innovative radiotherapy. (C) 2019 Elsevier B.V. All rights reserved.

KW - Time-driven activity-based costing

KW - Cost analysis

KW - Radiotherapy

KW - Healthcare provider perspective

KW - Hospital Financial Management

KW - INTENSITY-MODULATED RADIOTHERAPY

KW - EUROPEAN COUNTRIES

KW - GUIDELINES

KW - CANCER

KW - DEPARTMENTS

KW - MANAGEMENT

KW - EQUIPMENT

U2 - 10.1016/j.radonc.2019.06.015

DO - 10.1016/j.radonc.2019.06.015

M3 - Article

C2 - 31319281

SN - 0167-8140

VL - 138

SP - 187

EP - 194

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

ER -