title: [Process-oriented cost calculation in interventional radiology. A case study].
abstract: OBJECTIVE
  Currently used costing methods such as cost centre accounting do not sufficiently reflect the process-based resource utilization in medicine. The goal of this study was to establish a process-oriented cost assessment of percutaneous radiofrequency (RF) ablation of liver and lung metastases.
  
  
  METHODS
  In each of 15 patients a detailed task analysis of the primary process of hepatic and pulmonary RF ablation was performed. Based on these data a dedicated cost calculation model was developed for each primary process. The costs of each process were computed and compared with the revenue for in-patients according to the German diagnosis-related groups (DRG) system 2010.
  
  
  RESULTS
  The RF ablation of liver metastases in patients without relevant comorbidities and a low patient complexity level results in a loss of EUR 588.44, whereas the treatment of patients with a higher complexity level yields an acceptable profit. The treatment of pulmonary metastases is profitable even in cases of additional expenses due to complications.
  
  
  CONCLUSIONS
  Process-oriented costing provides relevant information that is needed for understanding the economic impact of treatment decisions. It is well suited as a starting point for economically driven process optimization and reengineering. Under the terms of the German DRG 2010 system percutaneous RF ablation of lung metastases is economically reasonable, while RF ablation of liver metastases in cases of low patient complexity levels does not cover the costs.
authors: Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland. andreas.mahnken@rwth-aachen.de
authors: A H
authors: AH
authors: Mahnken
authors: P
authors: P
authors: Bruners
authors: R W
authors: RW
authors: Günther
authors: C
authors: C
authors: Rasche
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000191:economics* / Q000601:surgery*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000191:economics* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019982:Organizational Case Studies; D017064:Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D015641:Radiography, Interventional / Q000191:economics* / Q000706:statistics & numerical data