title: IVF cycle cost estimation using Activity Based Costing and Monte Carlo simulation.
abstract: The Authors present a new methodological approach in stochastic regime to determine the actual costs of an healthcare process. The paper specifically shows the application of the methodology for the determination of the cost of an Assisted reproductive technology (ART) treatment in Italy. The reason of this research comes from the fact that deterministic regime is inadequate to implement an accurate estimate of the cost of this particular treatment. In fact the durations of the different activities involved are unfixed and described by means of frequency distributions. Hence the need to determine in addition to the mean value of the cost, the interval within which it is intended to vary with a known confidence level. Consequently the cost obtained for each type of cycle investigated (in vitro fertilization and embryo transfer with or without intracytoplasmic sperm injection), shows tolerance intervals around the mean value sufficiently restricted as to make the data obtained statistically robust and therefore usable also as reference for any benchmark with other Countries. It should be noted that under a methodological point of view the approach was rigorous. In fact it was used both the technique of Activity Based Costing for determining the cost of individual activities of the process both the Monte Carlo simulation, with control of experimental error, for the construction of the tolerance intervals on the final result.
authors.affiliation: DIME Dipartimento di Ingegneria Meccanica, Energetica, Gestionale e dei Trasporti, Università degli Studi di Genova, Via All'Opera Pia 15, 16145, Genova, Italy. cassettari@diptem.unige.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Cassettari
authors.affiliation: DIME Dipartimento di Ingegneria Meccanica, Energetica, Gestionale e dei Trasporti, Università degli Studi di Genova, Via All'Opera Pia 15, 16145, Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Mosca
authors.affiliation: DIME Dipartimento di Ingegneria Meccanica, Energetica, Gestionale e dei Trasporti, Università degli Studi di Genova, Via All'Opera Pia 15, 16145, Genova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Mosca
authors.affiliation: DIME Dipartimento di Ingegneria Meccanica, Energetica, Gestionale e dei Trasporti, Università degli Studi di Genova, Via All'Opera Pia 15, 16145, Genova, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Rolando
authors.affiliation: Ospedale Evangelico Internazionale, Corso Solferino, 1A, Genova, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Costa
authors.affiliation: Ospedale Evangelico Internazionale, Corso Solferino, 1A, Genova, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Pisaturo
mesh_terms: D003365:Costs and Cost Analysis / Q000379:methods*; D004624:Embryo Transfer / Q000191:economics* / Q000379:methods; D005307:Fertilization in Vitro / Q000191:economics* / Q000379:methods; D006801:Humans; D007558:Italy; D009010:Monte Carlo Method; D020554:Sperm Injections, Intracytoplasmic / Q000191:economics / Q000379:methods; D013269:Stochastic Processes
keywords: Activity Based Costing; Cost analysis; ICSI; IVF; Monte Carlo simulation; Stochastic modeling
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