Presentation (CTI)

OBJECTIVES: To determine the actual unit cost of a whole-body PET-CT scan in a government oncology hospital in North India using Time-Driven Activity-Based Costing (TDABC) and to identify cost-optimization opportunities for public diagnostic services.
METHODS: An observational cross-sectional study was conducted over 45 days in a 700-bed tertiary cancer hospital. Process mapping and time-motion analysis were performed for 100 consecutive PET-CT scans. Capacity cost rates (CCR) were calculated for manpower, equipment, and space based on annual cost and practical working minutes. Direct costs for consumables and electricity were added to derive per-scan cost. All estimates followed Kaplan and Anderson’s TDABC framework.
RESULTS: The total cost per whole-body PET-CT scan was ₹34,627 (USD 415), with equipment (48%) and consumables (22%) as primary cost drivers, followed by space (10%), manpower (10%), and electricity (8%). The patient charge of ₹7,500 reflects a 78% subsidy, consistent with India’s public-sector financing model. Sensitivity analysis indicated that operating the PET-CT unit in multi-shift mode could reduce per-scan cost by 27%. Low manpower share suggests under-staffing compared with international benchmarks, affecting optimal utilisation.
CONCLUSIONS: TDABC provides granular, evidence-based insights into the real cost structure of high-value diagnostic technologies in public hospitals. Findings highlight underutilisation of fixed assets and staffing gaps as key inefficiencies. Implementing multi-shift operations and strategic manpower planning can improve financial sustainability and access to advanced oncologic diagnostics within India’s public health system.