Publications
Publications
- February 8, 2022
- NEJM Catalyst
Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions
By: Alan Yang, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson and Robert S. Kaplan
Abstract
In 2017, patients made 145 million visits to emergency departments (EDs), generating $76.3 billion in charges. About a third of ED visits, however, were for conditions that were treatable in lower-resourced settings. We used time-driven activity-based costing (TDABC) to compare the actual resource costs, principally personnel, used to deliver care at an ED, a community urgent care center, an in-person primary care clinic, and a virtual primary care clinic for five frequent acute-onset and self-limited conditions: uncomplicated presentations of rash, conjunctivitis, urinary tract infection, migraine, and sprained ankle. As expected, ED care was the most expensive for all five conditions, even without any allocation of hospital overhead. Virtual care was the least costly except in the case of ankle sprains, where primary care was least costly. Costs at urgent care and primary care clinics were comparable. The findings suggest that healthcare systems can substantially lower costs for themselves and their patients by shifting the care for acute low-severity conditions away from EDs to lower-cost sites, especially virtual care clinics.
Keywords
Time-Driven ABC; Health Care Costs; Activity Based Costing and Management; Health Care and Treatment
Citation
Yang, Alan, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson, and Robert S. Kaplan. "Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions." NEJM Catalyst (February 8, 2022).