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
N1 - Funding Information:
This work has been performed in the framework of the Health Economics in Radiation Oncology project, initiated and financially supported by the European Society for Radiotherapy and Oncology . ESTRO did not intervene in the execution of this analysis, nor in the writing of the manuscript.
Publisher Copyright:
© 2019 Elsevier B.V.
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 -