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Comparison between Individually and Group-Based Insulin Pump Initiation by Time-Driven Activity-Based Costing

Ridderstråle, Martin LU (2017) In Journal of diabetes science and technology 11(4). p.759-765
Abstract

Background: Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. Methods: Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location. Medical quality and patient satisfaction were assumed to be noninferior and were not measured. Results: GT was about 30% less time-consuming and 17% less cost driving per patient and activity compared to IT. As a batch driver (16 patients in one group) GT produced an... (More)

Background: Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. Methods: Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location. Medical quality and patient satisfaction were assumed to be noninferior and were not measured. Results: GT was about 30% less time-consuming and 17% less cost driving per patient and activity compared to IT. As a batch driver (16 patients in one group) GT produced an upward jigsaw-shaped accumulative cost curve compared to the incremental increase incurred by IT. Taking the alternate cost for those not attending into account, and realizing the cost of opportunity gained, suggested that GT was cost neutral already when 5 of 16 patients attended, and that a second group could be initiated at no additional cost as the attendance rate reached 15:1. Conclusions: We found TDABC to be effective in comparing treatment alternatives, improving cost control and decision making. Everything else being equal, if the setup is available, our data suggest that initiating insulin pump treatment in groups is far more cost effective than on an individual basis and that TDABC may be used to find the balance point.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
diabetes, group treatment, insulin pump treatment, time-driven activity-based costing
in
Journal of diabetes science and technology
volume
11
issue
4
pages
7 pages
publisher
Diabetes Technology Society
external identifiers
  • scopus:85023188955
ISSN
1932-2968
DOI
10.1177/1932296816684858
language
English
LU publication?
yes
id
41b71306-9840-44d2-9a06-f2a37dc08ef0
date added to LUP
2017-08-03 14:59:02
date last changed
2017-08-04 03:00:13
@article{41b71306-9840-44d2-9a06-f2a37dc08ef0,
  abstract     = {<p>Background: Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. Methods: Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location. Medical quality and patient satisfaction were assumed to be noninferior and were not measured. Results: GT was about 30% less time-consuming and 17% less cost driving per patient and activity compared to IT. As a batch driver (16 patients in one group) GT produced an upward jigsaw-shaped accumulative cost curve compared to the incremental increase incurred by IT. Taking the alternate cost for those not attending into account, and realizing the cost of opportunity gained, suggested that GT was cost neutral already when 5 of 16 patients attended, and that a second group could be initiated at no additional cost as the attendance rate reached 15:1. Conclusions: We found TDABC to be effective in comparing treatment alternatives, improving cost control and decision making. Everything else being equal, if the setup is available, our data suggest that initiating insulin pump treatment in groups is far more cost effective than on an individual basis and that TDABC may be used to find the balance point.</p>},
  author       = {Ridderstråle, Martin},
  issn         = {1932-2968},
  keyword      = {diabetes,group treatment,insulin pump treatment,time-driven activity-based costing},
  language     = {eng},
  month        = {07},
  number       = {4},
  pages        = {759--765},
  publisher    = {Diabetes Technology Society},
  series       = {Journal of diabetes science and technology},
  title        = {Comparison between Individually and Group-Based Insulin Pump Initiation by Time-Driven Activity-Based Costing},
  url          = {http://dx.doi.org/10.1177/1932296816684858},
  volume       = {11},
  year         = {2017},
}