Cost of cardiac stereotactic body radioablation therapy versus catheter ablation for treatment of ventricular tachycardia

Abstract

Aims To compare the cost of cardiac stereotactic body radioablation therapy (SBRT) versus catheter ablation for treating ventricular tachycardia (VT). Background Cardiac SBRT is a novel way of treating refractory VT that may be less costly than catheter ablation, owing to its noninvasive, outpatient nature. However, the true costs of either procedure are not well described, which could help inform a more appropriate reimbursement for cardiac SBRT than simply cross‐indexing existing procedural rates. Methods Process maps were derived for the full patient care cycle of both procedures using time‐driven activity‐based costing. Step‐by‐step timestamps were collected prospectively from a 10‐patient SBRT cohort and retrospectively from a 59‐patient catheter ablation cohort. Individual costs were estimated by multiplying timestamps with capacity cost rates (CCRs) for personnel, space, equipment, consumable, and indirect resources. These were summed into total cost, which for cardiac SBRT was compared with current catheter ablation and single‐fraction lung SBRT reimbursements, both potential reference rates for cardiac SBRT. Results The direct and total procedural costs of cardiac SBRT ($7549 and $10,621) were 49% and 54% less than those of VT ablation ($14,707 and $23,225). These costs were significantly different from current reimbursement for catheter ablation ($22,692) and lung SBRT ($6329). After including hospitalization expenses (≥$15,000), VT ablation costs at least $27,604 more to furnish than cardiac SBRT. Conclusions Time‐driven activity‐based costing (TDABC) can be a helpful tool for assessing healthcare costs, including novel treatment approaches. In addition to its clinical benefits, cardiac SBRT may provide significant cost reduction opportunities for treatment of VT.

Aplicação do TDABC na avaliação da lucratividade de exames e do nível de ociosidade da tomografia computadorizada do setor de oncologia ginecológica

“…Quanto às aplicações do TDABC no contexto dos procedimentos hospitalares, algumas pesquisas recentes acentuaram os benefícios oriundos da utilização dessa ferramenta de custeio. Nesse sentido, Wei et al (2022) citam que o TDABC pode ser útil para avaliar os custos na área da saúde, inclusive no âmbito de novas abordagens de tratamentos. Thaker et al (2022) registram que o TDABC possibilita medir o uso de recursos ao longo de todo o ciclo de atendimento, o que contribui para melhorar a eficiência do fluxo de trabalho e minimizar os custos dos procedimentos médicos.…”