A quantitative and qualitative analysis of Time-Driven Activity Based Costing: the waste side of joint replacement

A quantitative and qualitative analysis of Time-Driven Activity Based Costing: the waste side of joint replacement

Authors

  • Andrea Fidanza Unit of Orthopaedic Surgery, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
  • Irene Schettini Department of Management and Law, Tor Vergata University of Rome, Via Columbia 2, 00133 Roma, Italy
  • Francesco Di Petrillo Unit of Orthopaedic Surgery, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
  • Michela Saracco Department of Orthopaedics, “San Giovanni di Dio” Hospital, ASL Napoli 2 Nord, Napoli, Italy
  • Giuseppe Petralia Unit of Orthopaedic Surgery, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
  • Giandomenico Logroscino Unit of Orthopaedic Surgery, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy

Keywords:

TDABC, Joint replacement, prosthetic costs, hospital costs, Value-based healthcare, cost drivers

Abstract

Background and aim: The Time-Driven Activity Based Costing (TDABC) is a recent and sophisticated analytical accounting systems capable of linking and summarizing the information held by the various stakeholders involved in the provision of health care services. The aim of this review is to quantify the current state of the art of the international TDACB literature in the orthopaedic field, highlighting which orthopaedic topic deriving from the clinical/economic interdisciplinarity is of greater interest. Methods: A comprehensive science mapping bibliometric analysis of scientific literature was performed using the Scopus database. Afterwards, the analysis of the 40 most cited articles was carried out to spotlight the area of greatest interest in the orthopaedic field, and from which to extrapolate a qualitative analysis. Results: A total of 346 documents resulted eligible for the review. Nine of 40 articles examined TDABC in the prosthetic context. Despite showing a high diversity of methodological application, all 9 articles agree on the two most expensive items of care cycles: operating room consumables followed by length of stay. Conclusion: TDABC is a cost calculation methodology that is gaining scientific attention in the orthopaedic world, particularly in the joint replacement area. This tool might be useful for both clinicians and business managers, allowing them to redesign the entire patient care path, making useful changes to reduce waste, while maintaining standards of care.

References

Javid M, Hadian M, Ghaderi H, Ghaffari S, Salehi M. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital. Glob J Health Sci. 2015 17;8(1):165-72. doi: 10.5539/gjhs.v8n1p165.

Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harv Bus Rev. 2011 Sep;89(9):46-52, 54, 56-61 passim. PMID: 21939127.

Porter ME. Value-based health care delivery. Ann Surg. 2008 Oct;248(4):503-9. doi: 10.1097/SLA.0b013e31818a43af.

Porter ME. A strategy for health care reform--toward a value-based system. N Engl J Med. 2009 Jul 9;361(2):109-12. doi: 10.1056/NEJMp0904131.

Porter ME. What is value in health care? N Engl J Med. 2010 Dec 23;363(26):2477-81. doi: 10.1056/NEJMp1011024

Fidanza A, Schettini I, Palozzi G, et al. What Is the Inpatient Cost of Hip Replacement? A Time-Driven Activity Based Costing Pilot Study in an Italian Public Hospital. J Clin Med. 2022 Nov 24;11(23):6928. doi: 10.3390/jcm11236928

Kaplan RS, Porter ME, Frigo ML. Managing Healthcare Costs and Value. Strategic Finance 98, no. 7. 2017. : 24–33.

Keel G, Savage C, Rafiq M, Mazzocato P. Time-driven activity-based costing in health care: A systematic review of the literature. Health Policy. 2017 Jul;121(7):755-763. doi: 10.1016/j.healthpol.2017.04.013

Etges APBDS, Ruschel KB, Polanczyk CA, Urman RD. Advances in Value-Based Healthcare by the Application of Time-Driven Activity-Based Costing for Inpatient Management: A Systematic Review. Value Health. 2020 Jun;23(6):812-823. doi: 10.1016/j.jval.2020.02.004

Campanale C, Cinquini L, Tenucci A. Time‐Driven Activity‐Based Costing to Improve Transparency and Decision Making in Healthcare: A Case Study. Qualitative Research in Accounting & Management. 2014. 11 (2): 165–86. doi:10.1108/QRAM-04-2014-0036

Kaplan RS. Improving value with TDABC. Healthc Financ Manage. 2014 Jun;68(6):76-83. PMID: 24968629.

Porter ME. What Is Value in Health Care? N Engl J Med. 2010. 363(26):2477-2481. doi:10.1056/NEJMp1011024

Brooks, Terrence A. 1996. «Dictionary of Bibliometrics». JSTOR

Aria M, Cuccurullo C. Bibliometrix: An R‐tool for comprehensive science mapping analysis. Journal of Informetrics. 2017. 11 (4): 959–75. doi: https://doi.org/10.1016/j.joi.2017.08.007.

Dadkhah M, Lagzian M, Rahimnia F, Kimiafar K. What Do Publications Say about the Internet of Things Challenges/Barriers to Uninformed Authors? A Bibliometric Analysis. JLIS.It. 2017. 11 (3):77-98. Doi:https://doi.org/10.4403/jlis.it-12634.

Van Raan A. The use of bibliometric analysis in research performance assessment and monitoring of interdisciplinary scientific developments. TATuP. 2003 Apr. 12(1):20-9. DOI:https://doi.org/10.14512/tatup.12.1.20.

Cobo M J, López‐Herrera A G, Herrera‐Viedma E, Herrera F. An approach for detecting, quantifying, and visualizing the evolution of a research field: A practical application to the fuzzy sets theory field. Journal of informetrics. 2011. 5 (1): 146–66. Doi: https://doi.org/10.1016/j.joi.2010.10.002

Childers CP, Maggard-Gibbons M. Understanding Costs of Care in the Operating Room. JAMA Surg. 2018 Apr. 18;153(4):e176233. doi: 10.1001/jamasurg.2017.6233

Jessup RL, Tacey M, Glynn M, Kirk M, McKeown L. Evaluation of the effectiveness of a comprehensive care plan to reduce hospital acquired complications in an Australian hospital: protocol for a mixed-method preimplementation and postimplementation study. BMJ Open. 2020 Jul 20;10(7):e034121. doi: 10.1136/bmjopen-2019-034121.

Niñerola A, Hernández-Lara AB, Sánchez-Rebull MV. Improving healthcare performance through Activity-Based Costing and Time-Driven Activity-Based Costing. Int J Health Plann Manage. 2021 Nov;36(6):2079-2093. doi: 10.1002/hpm.3304

Du JY, Rascoe AS, Marcus RE. The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System. Clin Orthop Relat Res. 2018 Oct;476(10):1910-1919. doi: 10.1097/CORR.0000000000000394.

Akhavan S, Ward L, Bozic KJ. Time-driven Activity-based Costing More Accurately Reflects Costs in Arthroplasty Surgery. Clin Orthop Relat Res. 2016 Jan;474(1):8-15. doi: 10.1007/s11999-015-4214-0.

DiGioia AM 3rd, Greenhouse PK, Giarrusso ML, Kress JM. Determining the True Cost to Deliver Total Hip and Knee Arthroplasty Over the Full Cycle of Care: Preparing for Bundling and Reference-Based Pricing. J Arthroplasty. 2016 Jan;31(1):1-6. doi: 10.1016/j.arth.2015.07.013.

Palsis JA, Brehmer TS, Pellegrini VD, Drew JM, Sachs BL. The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty. J Bone Joint Surg Am. 2018 Feb 21;100(4):326-333. doi: 10.2106/JBJS.17.00161

Haas DA, Kaplan RS. Variation in the cost of care for primary total knee arthroplasties. Arthroplast Today. 2016 Sep 30;3(1):33-37. doi: 10.1016/j.artd.2016.08.001

Andreasen SE, Holm HB, Jørgensen M, Gromov K, Kjærsgaard-Andersen P, Husted H. Time-driven Activity-based Cost of Fast-Track Total Hip and Knee Arthroplasty. J Arthroplasty. 2017 Jun;32(6):1747-1755. doi: 10.1016/j.arth.2016.12.040

Chen A, Sabharwal S, Akhtar K, Makaram N, Gupte CM. Time-driven activity-based costing of total knee replacement surgery at a London teaching hospital. Knee. 2015 Dec;22(6):640-5. doi: 10.1016/j.knee.2015.07.006

Menendez ME, Lawler SM, Shaker J, Bassoff NW, Warner JJP, Jawa A. Time-Driven Activity-Based Costing to Identify Patients Incurring High Inpatient Cost for Total Shoulder Arthroplasty. J Bone Joint Surg Am. 2018 Dec 5;100(23):2050-2056. doi: 10.2106/JBJS.18.00281

Husted H, Kristensen BB, Andreasen SE, et al. Time-driven activity-based cost of outpatient total hip and knee arthroplasty in different set-ups. Acta Orthop. 2018 Oct;89(5):515-521. doi: 10.1080/17453674.2018.1496309

Carducci MP, Gasbarro G, Menendez ME, et al. Variation in the Cost of Care for Different Types of Joint Arthroplasty. J Bone Joint Surg Am. 2020 Mar 4;102(5):404-409. doi: 10.2106/JBJS.19.00164

Hamid KS, Matson AP, Nwachukwu BU, Scott DJ, Mather RC 3rd, DeOrio JK. Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements. Foot Ankle Int. 2017 Jan;38(1):49-57. doi: 10.1177/1071100716667505

Finkler SA, Ward DM, Baker JJ. Essentials of cost accounting for health care organizations. Sudbury, Mass.: Jones and Bartlett Publishers, 2007

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Published

21-06-2024

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How to Cite

1.
Fidanza A, Schettini I, Di Petrillo F, Saracco M, Petralia G, Logroscino G. A quantitative and qualitative analysis of Time-Driven Activity Based Costing: the waste side of joint replacement. Acta Biomed. 2024;95(3):e2024034. doi:10.23750/abm.v95i3.15387