Department of Radiation Oncology, University Hospitals Gasthuisberg, Leuven, Belgium.
Radiother Oncol. 2012 Jan;102(1):148-53. doi: 10.1016/j.radonc.2011.07.033. Epub 2011 Aug 26.
To quantify changes in radiotherapy costs occurring in a decade of medical-technological evolution.
The activity-based costing (ABC) model of the University Hospitals Leuven (UHL) radiotherapy (RT) department was adapted to current RT standards. It allocated actual resource costs to the treatments based on the departmental work-flow and patient mix in 2009. A benchmark with the former model analyzed the cost increases related to changes in RT infrastructure and practice over 10 years.
A considerable increase in total RT costs was observed, resulting from higher capital investments (96%) and personnel cost (103%), the latter dominating the total picture. Treatment delivery remains the most costly activity, boosted by the cost of improved quality assurance (QA), 23% of total product costs, coming along with more advanced RT techniques. Hence, cost increases at the product level are most obvious for complex treatments, such as intensity-modulated radiotherapy (IMRT), representing cost increases ranging between 38% and 88% compared to conformal approaches.
The ABC model provides insight into the financial consequences of evolving technology and practice. Such data are a mandatory first step in our strive to prove RT cost-effectiveness and thus support optimal reimbursement and provision of radiotherapy departments.
定量分析医疗技术发展十年间放射治疗成本的变化。
莱顿大学医院（UHL）放射治疗（RT）部门的作业成本法（ABC）模型经过调整，以适用于当前的 RT 标准。它根据部门的工作流程和 2009 年的患者构成，将实际资源成本分配到治疗中。与前一个模型的基准分析了 10 年来 RT 基础设施和实践变化所导致的成本增加。
观察到 RT 总成本的显著增加，这是由于资本投资（96%）和人员成本（103%）的增加所致，后者在总图景中占主导地位。治疗提供仍然是最昂贵的活动，得益于质量保证（QA）成本的提高，占总产品成本的 23%，同时也伴随着更先进的 RT 技术。因此，在产品层面上，成本增加最明显的是复杂治疗，如强度调制放疗（IMRT），与适形方法相比，成本增加了 38%至 88%不等。
ABC 模型提供了对不断发展的技术和实践所带来的财务后果的深入了解。这些数据是我们努力证明 RT 的成本效益并支持放射治疗部门的最佳报销和供应的强制性第一步。
