PND21 A Tool Proposal For Measuring Costs Using Time-Driven Activity-Based Costing For The Ischemic Stroke Care Pathway

Abstract

The micro-costing technique with Time-Driven Activity-Based Costing (TDABC) is being used for achieving high-accuracy cost information, but there is still a lack of standardization on its application, and it is usually time-consuming. This study developed a tool to automatize measures and analyses of costs using data collected for a TDABC study. Visual Basics for Applications language in Microsoft Excel® 2019 was used for coding. Data of 410 ischemic stroke patients from 4 Brazilian hospitals were used as input for the tool, allowing standardization of the information needed for it to run. The tool outcomes considered the most frequent TDABC analyses, like cost per phases of the care cycle, resources, and therapy. The tool was run ten times per hospital, and a mean time per running was considered to evaluate its performance. Finally, three researchers who already performed micro-costing TDABC studies manually were questioned about the time-savings when using the tool. The tool automatized the cost per patient's analysis, the stratification of the costs by phases of the care cycle and resources for each patient from each hospital. The mean time per patient to run the tool was 0.77 seconds (SD 0.11). The researchers reported a mean dedication time of one hour per patient analyzed by manually doing the same process. The tool also provided the mean cost per hour of each phase for different patient's therapy groups, allowing the development of forecasting models for estimating the cost of the stroke care pathway. The accurate costs measured by the micro-costing TDABC studies can still be improved by developing a more standardized and faster implementation process. The tool built in this study allowed to simplify, accelerate, and standardize the TDABC application in health care and the scalability of cost estimates with TDABC for the ischemic stroke care pathway.