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Time‐driven activity‐based costing to estimate cost of care at multidisciplinary aerodigestive centers
Author(s) -
Garcia Jordan A.,
Mistry Bipin,
Hardy Stephen,
Fracchia Mary Shan,
Hersh Cheryl,
Wentland Carissa,
Vadakekalam Joseph,
Kaplan Robert,
Hartnick Christopher J.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26354
Subject(s) - medicine , multidisciplinary approach , activity based costing , health care , retrospective cohort study , emergency medicine , medical emergency , surgery , social science , marketing , sociology , economics , business , economic growth
Objectives/Hypothesis Providing high‐value healthcare to patients is increasingly becoming an objective for providers including those at multidisciplinary aerodigestive centers. Measuring value has two components: 1) identify relevant health outcomes and 2) determine relevant treatment costs. Via their inherent structure, multidisciplinary care units consolidate care for complex patients. However, their potential impact on decreasing healthcare costs is less clear. The goal of this study was to estimate the potential cost savings of treating patients with laryngeal clefts at multidisciplinary aerodigestive centers. Study Design Retrospective chart review. Methods Time‐driven activity‐based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic utilization by patients as well as patient diet outcomes after treatment. Patients were stratified into neurologically complex and neurologically noncomplex groups. Results The cost of care for patients requiring surgical intervention was five and three times as expensive of the cost of care for patients not requiring surgery for neurologically noncomplex and complex patients, respectively. Following treatment, 50% and 55% of complex and noncomplex patients returned to normal diet, whereas 83% and 87% of patients experienced improved diets, respectively. Additionally, multidisciplinary team‐based care for children with laryngeal clefts potentially achieves 20% to 40% cost savings. Conclusions These findings demonstrate how time‐driven activity‐based costing can be used to estimate and compare patient costs in multidisciplinary aerodigestive centers. Level of Evidence 2c. Laryngoscope , 127:2152–2158, 2017