Busschaert Sara-Lise, Werbrouck Amber, De Ridder Mark, Putman Koen
Department of Public Health, Research Centre on Digital Medicine (REDM), Vrije Universiteit Brussel, Brussels, Belgium; Department of Radiotherapy, Research Centre on Digital Medicine (REDM), University Hospital Brussels, Brussels, Belgium.
Department of Public Health, Research Centre on Digital Medicine (REDM), Vrije Universiteit Brussel, Brussels, Belgium.
Value Health. 2025 Apr;28(4):643-651. doi: 10.1016/j.jval.2024.11.003. Epub 2024 Nov 26.
Time-driven activity-based costing (TD-ABC) holds promise to control costs and enhance value in oncology, but the current landscape of its applications remains uncharted. This study aimed to: (1) document the applications of TD-ABC in oncology and unveil its strengths and limitations, (2) assess the extent to which studies adhere to Kaplan and Porter's method, and (3) appraise study quality.
A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. To be eligible for inclusion, studies had to provide an empirical application of TD-ABC within oncology. Structured data extraction included key characteristics such as cancer type, perspective, and analysis setting. Quality was assessed using the TD-ABC Healthcare Consortium Consensus Statement checklist.
A total of 59 studies met the inclusion criteria, two-thirds of which were published within the last 5 years. Most studies were conducted in high-income countries and analyzed common cancer types. The provider's perspective (85%) dominated, and studies typically relied on single-institution data (76%). No study assessed costs over a complete cycle of care and most focused on the costs of radiotherapy (56%) or surgery (20%). Articles generally did not adhere to the seven-step method, and average study quality was low (52%), particularly because of inadequate content in methods and results.
Oncology has emerged as a productive field for TD-ABC analyses, showcasing the effectiveness of TD-ABC in capturing the costs of healthcare processes in which medical devices are integral to care delivery. Nevertheless, concerns arise because of the low overall study quality and the lack of a consistent methodology.
基于时间驱动作业成本法（TD-ABC）有望控制肿瘤治疗成本并提升价值，但目前其应用情况仍不明朗。本研究旨在：（1）记录TD-ABC在肿瘤学中的应用情况，揭示其优势与局限；（2）评估各研究遵循卡普兰和波特方法的程度；（3）评价研究质量。
按照系统评价与Meta分析的首选报告项目指南进行系统评价。纳入研究必须提供TD-ABC在肿瘤学中的实证应用。结构化数据提取包括癌症类型、视角和分析背景等关键特征。使用TD-ABC医疗保健联盟共识声明清单评估质量。
共有59项研究符合纳入标准，其中三分之二是在过去5年内发表的。大多数研究在高收入国家进行，分析的是常见癌症类型。提供者视角（85%）占主导，研究通常依赖单机构数据（76%）。没有研究评估整个护理周期的成本，大多数研究关注放疗成本（56%）或手术成本（20%）。文章普遍未遵循七步法，平均研究质量较低（52%），特别是在方法和结果方面内容不足。
肿瘤学已成为TD-ABC分析的一个富有成效的领域，展示了TD-ABC在捕捉医疗设备是护理交付不可或缺部分的医疗保健过程成本方面的有效性。然而，由于整体研究质量较低和缺乏一致的方法，令人担忧。
