OBJECTIVE To compare costs between enucleation and plaque brachytherapy procedures for the treatment of intraocular malignancies. DESIGN Retrospective economic analysis using a time-driven activity-based costing (TDABC) methodology. SUBJECTS Patients undergoing plaque brachytherapy and enucleation procedures for the treatment of intraocular malignancy performed at the University of Michigan Kellogg Eye Center from 2021-2022. METHODS Data inputs were obtained from the Electronic Health Record (EHR) and prior literature. Associated expenses were determined using TDABC, a method for cost calculation that correlates the cost rate of each resource used in a procedure with the amount of time that the resource is used. MAIN OUTCOME MEASURES The primary outcome was the difference in total cost associated with enucleation versus plaque brachytherapy procedures. Secondary outcomes included length of surgery (in minutes), total day-of-surgery costs, and number of follow-up visits. RESULTS 145 cases were included, with 41 enucleations and 104 courses of plaque brachytherapy.. Between all enucleation and plaque brachytherapy procedures, plaque brachytherapy was significantly more costly ($10,140.95 vs. $6,127.70, P < 0.01), with total difference in cost of $4013 (95% confidence interval $3352.02 to $4674.47). There was no significant difference in OR time between enucleation and plaque brachytherapy. Plaque brachytherapy required significantly more follow-up visits than enucleation (1.02 visits vs. 0.59 visits, P < 0.01). CONCLUSIONS Through TDABC cost analysis, we determined that the surgical course of plaque brachytherapy is more costly than enucleation, with the primary cost drivers being cost of the radiotherapy plaque and radiation oncology-related expenses.

中文翻译：

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眼内恶性肿瘤眼内恶性肿瘤眼球摘除术与斑块近距离放射治疗的手术费用：一种时间驱动的基于活动的成本计算方法。


目的 比较眼球摘除术和斑块近距离放射治疗手术治疗眼内恶性肿瘤的成本。设计 使用时间驱动的基于活动的成本核算 （TDABC） 方法的回顾性经济分析。对象 2021-2022 年在密歇根大学凯洛格眼科中心接受斑块近距离放射治疗和眼内恶性肿瘤摘除手术的患者。方法 数据输入来自电子健康记录 （EHR） 和以前的文献。相关费用是使用 TDABC 确定的，TDABC 是一种成本计算方法，它将过程中使用的每种资源的成本率与资源的使用时间相关联。主要结局指标 主要结局是与眼球摘除术与斑块近距离放射治疗程序相关的总成本的差异。次要结局包括手术时间（以分钟为单位）、手术总日费用和随访次数。结果 共纳入 145 例，其中 41 例眼球摘除术和 104 个疗程的斑块近距离放射治疗。在所有眼球摘除术和斑块近距离放射治疗程序之间，斑块近距离放射治疗的成本明显更高 （10,140.95 美元 vs. 6,127.70 美元，P < 0.01），总成本差异为 4013 美元 （95% 置信区间 3352.02 美元至 4674.47 美元）。眼球摘除术和斑块近距离放射治疗之间的 OR 时间没有显著差异。斑块近距离放射治疗需要的随访次数明显多于眼球摘除术 （1.02 次就诊 vs. 0.59 次就诊，P < 0.01）。结论 通过 TDABC 成本分析，我们确定斑块近距离放射治疗的手术过程比眼球摘除术更昂贵，主要成本驱动因素是放疗斑块的成本和放射肿瘤学相关费用。