Time-Driven Activity-Based Costing (TDABC) applied in a chemotherapy department of a public reference oncology hospital

Abstract

ABSTRACT Objective: To identify the costs pertaining to the preparation and administration process of each chemotherapy treatment session in a public oncology hospital belonging to the Brazilian Unified Health System. Methods: This prospective, observational, and descriptive study employs the bottom-up micro-costing method through Time-Driven Activity-Based Costing, from the perspective of the facilities of a chemotherapy department within a public oncology hospital. Results: A comprehensive overview of the flow related to outpatient antineoplastic therapy was elaborated through process mapping, which included each step required for a treatment session. Total personnel costs were calculated at R$ 287,66, distributed among the nursing (48.81%), pharmacy (18.66%), clinical analysis (16.27%), and clinical oncology (16.27%) sectors. The total cost of one intravenous antineoplastic therapy session per patient, excluding the cost of the antineoplastic drug, was R$ 470,35. Nursing care accounted for 49.88% (R$ 234,61) of the financial resources used per session, while pharmacy, clinical analysis, and clinical oncology accounted for 24.47%, 15.70%, and 9.95% of the costs, respectively. Conclusion: Employing the Time-Driven Activity-Based Costing method in health services not only facilitates resource optimization, providing quality and efficient care within constrained budgets, but also enhances control over processes and their financing.

Keywords

• Micro-costing
• Costs and cost analysis
• Antineoplastic agents
• Drug therapy
• Medical oncology
• Health care costs
• Technology assessment, biomedical
• Health services
• Unified health system