Costing of radiotherapy services
Activity Based Funding Taskforce within the NSW Ministry of Health
Duration: October 2015 – June 2016
Hospitals that provide radiotherapy services commonly experience a significant increase in hospital operating costs, relating both to direct patient care and indirect or infrastructure costs of radiotherapy technology. The drivers of cost and the cost differential for different types of radiotherapy services are currently not captured in the NSW cost data reported in the District and Network Return. This project was undertaken to examine the detailed service and cost inputs associated with the radiotherapy treatment and to identify the full cost of radiotherapy services. It is expected that the findings of this review will be used to improve the methodology for costing radiotherapy and eventually also inform the funding of radiotherapy services in NSW.
What we did
The project involved data analysis, stakeholder consultations with multidisciplinary radiotherapy teams, detailed process mapping, and a review of costing methods in six selected NSW radiotherapy services. The review provided justification for the increased cost of radiotherapy services and identified multiple sources of funding.
The analysis utilised data collected from the process mapping, clinical costing outputs from the District and Network Return and financial data. Reports from the Radiotherapy Information System were also accessed for two of the sites to assist in mapping the patient journey through a course of radiotherapy.
One key output of this review included a conceptual model for radiotherapy care that identified some activities that were common to all radiotherapy care and others that were indicators of service complexity and cost (based on staff time) for different courses of treatment.
A new radiotherapy costing standard was developed to be included in the NSW Cost Accounting Guidelines. The cornerstone of this new costing standard is a standardised extract from the Radiotherapy Information System that enables the mapping of service activities to be costed. Relative value units were developed for each of these activities to support a more accurate allocation of costs.
The categories and types of activities, complexity bandings, and resource input types were defined and the total full costs of the radiotherapy service for each centre were estimated. The total average costs of the individual service events and for a course of radiotherapy treatment were calculated based on the total costs for each centre.
Photo by Michael Anderson