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Scientific Oral Presentations

Business of Medicine/Practice Management

Session: Scientific Oral Presentations - Business of Medicine/Practice Management

Time-Driven Activity-Based Costing (TDABC) in Otolaryngology: A Scoping Review

Sunday, September 29, 2024
3:12 PM – 3:18 PM EDT
Location: MBCC, 233
Disclosure(s):
Eric K. Kim, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Increasing healthcare value can benefit patients, providers, and health systems, but accurate cost measuring is critical. The objective of this study was to review Time-Driven Activity-Based Costing (TDABC) in otolaryngology and to illustrate areas where value may be increased.

Methods: A comprehensive literature search was performed in PubMed, Web of Science, Embase, CINAHL Complete, and Business Source Complete from database inception to June 2023. Review selection and characterization were performed by 3 independent reviewers. Inclusion criteria consisted of English peer-reviewed articles that analyzed an otolaryngology care process utilizing TDABC. Data collected included study characteristics, process mapping methodology, team members accounted for, costing calculations, and key study findings.

Results: In total, 213 studies were screened and 8 studies were included for full review. Subspecialties consisted of: pediatric otolaryngology (4), head and neck surgery (2), and rhinology (2). All studies used stakeholder input and/or direct observation to create process maps. Staffing in surgical interventions consistently contributed more to costs than consumables, and intraoperative phases of care more than preoperative or postoperative. One study, assessing staffing models, found per-case personnel costs decreased by 23.3% when surgeons ran two operating rooms. Two studies examining dysphagia and laryngeal clefts also found cost savings with multidisciplinary clinics.

Conclusions: This is the first comprehensive review of TDABC in otolaryngology. The majority of studies found the highest costs associated with staffing personnel. Potential cost saving avenues included running two operating rooms and multidisciplinary clinics. Ongoing research in the field should explore other methods to optimize healthcare value.

    Presenting Author(s)

  • EK

    Eric K. Kim, MD

    Resident Physician
    University of California, San Francisco
    San Francisco, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • AL

    Alice Liu, MD

    Resident Physician
    University of British Columbia
    Vancouver, British Columbia, Canada

    Disclosure information not submitted.

  • HA

    Hasan Abdulbaki

    University of California, San Francisco, California, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • NJ

    Nicole T. Jiam, MD

    Otology, Neurotology & Skull Base Surgery
    Harvard Medical School & Massachusetts Eye and Ear
    Boston, Massachusetts, United States

    Disclosure information not submitted.