Novel Strategy Determines Cost of Prostate Condition Treatments

A novel costing strategy has been used to determine the cost of care across the entire care process for benign prostate hyperplasia (BPH), according to researchers from the University of California, Los Angeles (UCLA). The results of their study were published in The Journal of Delivery Science and Innovation.

The time-driven, activity-based costing strategy revealed a 400% discrepancy between the most and least expensive treatment options for BPH just within UCLA. According to lead author Alan Kaplan, MD, a resident physician in the UCLA Department of Urology, the findings are particularly important in BPH because there aren’t any proven difference in outcomes between higher and lower cost treatments.

“The rising cost of health care is unsustainable, and a big part of the problem is that health systems, health care providers and policy makers have a poor understanding of how much health care really costs,” Dr Kaplan said in a statement. “Until this is well understood, taxpayers, insurers and patients alike will continue to bear the burden of soaring health care costs.”

The researchers implemented the time-drive, activity-based costing strategy across the entire care pathway for BPH, including primary and specialist care in both inpatient and outpatient settings.

“Cost can be a dirty word in medicine,” Dr Kaplan said. “People want the best healthcare money can buy. A poor understanding of healthcare costs means a lot of waste and unnecessary expenses that are borne mostly by patients.”

They found that invasive diagnostic testing, which is listed as “optional” in practice guidelines, can increase costs by 150% compared with the standalone urology clinic visit.

Invasive procedures, which can range from in-office minimally invasive to outpatient surgery to inpatient open surgery, are often needed for patients when medical therapies are no longer effective.

“As financial risk is shifted toward providers, understanding the cost of care will be vital,” the authors concluded. “Future work is needed to determine outcome discrepancy between the diagnostic and surgical modalities in BPH.”