Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institution
Background Cancer care requires coordinated, multi-disciplinary teams and incurs rising costs. Time-driven activity-based costing (TDABC) calculates the costs of healthcare resources consumed along the care process. We used TDABC to evaluate the cost of selected adjuvant and palliative regimens in b...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-06-01
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| Series: | Proceedings of Singapore Healthcare |
| Online Access: | https://doi.org/10.1177/20101058251355293 |
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| author | Evelyn Yi Ting Wong Renne Phay Gemma Diente Peralta Sharon Keman Chee Joanne Ngeow |
| author_facet | Evelyn Yi Ting Wong Renne Phay Gemma Diente Peralta Sharon Keman Chee Joanne Ngeow |
| author_sort | Evelyn Yi Ting Wong |
| collection | DOAJ |
| description | Background Cancer care requires coordinated, multi-disciplinary teams and incurs rising costs. Time-driven activity-based costing (TDABC) calculates the costs of healthcare resources consumed along the care process. We used TDABC to evaluate the cost of selected adjuvant and palliative regimens in breast, colorectal, and lung cancer at a single institution to inform resource allocation. Methods Process maps of the care delivery cycle were developed using TDABC, detailing each clinic or ambulatory treatment unit visit. Resources—including personnel, equipment, and supplies—were identified at each step. Per-minute costs were generated based on time requirements, and total costs calculated by summing resource expenses per episode of care. Results The total cost per chemotherapy regimen varied significantly across cancer types and settings. For breast cancer, adjuvant Adriamycin-Cyclophosphamide-Paclitaxel over 24 weeks cost SGD$17,075.43, driven by manpower utilization (2.976 man-units) and chair time (4350.93 minutes). Metastatic Docetaxel, given every three weekly, cost SGD$3174.65 over 6 weeks, while weekly Paclitaxel cost SGD$6810.79 due to increased chair time (2606.57 minutes). For lung cancer, Pemetrexed-Carboplatin-Pembrolizumab cost SGD$25,711.17, versus SGD$13,992.05 for Osimertinib. Gastrointestinal regimens ranged from SGD$9548.43 for adjuvant Capecitabine-Oxaliplatin to SGD$1264.52 for palliative Capecitabine. Outpatient base costs averaged SGD$310 per visit, with additional costs driven by chemotherapy type, frequency, manpower, and adverse drug reaction management. Conclusion TDABC application in oncology is limited but integral to value-based care. Understanding actual costs and cost drivers in outpatient cancer care may better inform resource use during times of constraint. |
| format | Article |
| id | doaj-art-7e5aa0388ab04c4a867206d4265f4eb4 |
| institution | Kabale University |
| issn | 2059-2329 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Proceedings of Singapore Healthcare |
| spelling | doaj-art-7e5aa0388ab04c4a867206d4265f4eb42025-08-20T03:31:53ZengSAGE PublishingProceedings of Singapore Healthcare2059-23292025-06-013410.1177/20101058251355293Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institutionEvelyn Yi Ting WongRenne PhayGemma Diente PeraltaSharon Keman CheeJoanne NgeowBackground Cancer care requires coordinated, multi-disciplinary teams and incurs rising costs. Time-driven activity-based costing (TDABC) calculates the costs of healthcare resources consumed along the care process. We used TDABC to evaluate the cost of selected adjuvant and palliative regimens in breast, colorectal, and lung cancer at a single institution to inform resource allocation. Methods Process maps of the care delivery cycle were developed using TDABC, detailing each clinic or ambulatory treatment unit visit. Resources—including personnel, equipment, and supplies—were identified at each step. Per-minute costs were generated based on time requirements, and total costs calculated by summing resource expenses per episode of care. Results The total cost per chemotherapy regimen varied significantly across cancer types and settings. For breast cancer, adjuvant Adriamycin-Cyclophosphamide-Paclitaxel over 24 weeks cost SGD$17,075.43, driven by manpower utilization (2.976 man-units) and chair time (4350.93 minutes). Metastatic Docetaxel, given every three weekly, cost SGD$3174.65 over 6 weeks, while weekly Paclitaxel cost SGD$6810.79 due to increased chair time (2606.57 minutes). For lung cancer, Pemetrexed-Carboplatin-Pembrolizumab cost SGD$25,711.17, versus SGD$13,992.05 for Osimertinib. Gastrointestinal regimens ranged from SGD$9548.43 for adjuvant Capecitabine-Oxaliplatin to SGD$1264.52 for palliative Capecitabine. Outpatient base costs averaged SGD$310 per visit, with additional costs driven by chemotherapy type, frequency, manpower, and adverse drug reaction management. Conclusion TDABC application in oncology is limited but integral to value-based care. Understanding actual costs and cost drivers in outpatient cancer care may better inform resource use during times of constraint.https://doi.org/10.1177/20101058251355293 |
| spellingShingle | Evelyn Yi Ting Wong Renne Phay Gemma Diente Peralta Sharon Keman Chee Joanne Ngeow Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institution Proceedings of Singapore Healthcare |
| title | Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institution |
| title_full | Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institution |
| title_fullStr | Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institution |
| title_full_unstemmed | Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institution |
| title_short | Resource allocation for hospitals (Reach): A time-driven activity-based costing study of chemotherapy regimens in a single institution |
| title_sort | resource allocation for hospitals reach a time driven activity based costing study of chemotherapy regimens in a single institution |
| url | https://doi.org/10.1177/20101058251355293 |
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