Time-Driven Activity-Based Costing of Sclerotherapy for the Treatment of Venous Malformations at a National Referral Hospital in Tanzania.

PURPOSE: To use time-driven activity-based costing (TDABC) to evaluate costs associated with locally performing sclerotherapy for the treatment of venous malformations (VMs) in Tanzania in comparison with treatment abroad.

MATERIALS AND

METHODS

A single-center retrospective cost analysis was performed on 102 consecutive polidocanol foam sclerotherapy sessions on 53 patients from September 2022 to April 2024 for treatment of VMs in Tanzania. Using TDABC, process maps detailing the VM care cycle were developed into 4 stages: clinic, before intervention, intervention, and after intervention. Time allocation of resources, including labor, was evaluated using survey data and input from involved medical and accounting staff.

RESULTS

The total TDABC cost of VM treatment was $538.61. Resource utilization accounted for 81.8% ($440.58) of the cost, and labor accounted for 18.2% ($98.02). The clinic stage accounted for 4.0% ($21.30) of the cost; before intervention, 53.8% ($289.85); intervention, 33.9% ($182.64); and after intervention, 8.4% ($45.00). Magnetic resonance (MR) imaging utilization was overall the largest contributing cost: 36.6% ($197).

CONCLUSIONS

The calculated cost of VM treatment in Tanzania was 7.69 times less than the primary alternative treatment pathway, referral abroad (quoted at $4,140)-highlighting the potential cost effectiveness of investing in local interventional radiology services to address patient needs in underserved settings. Such analysis is vital in resource-limited populations, where weighing costs and health benefits ensures the most efficient use of scarce healthcare resources.