Time-Driven Activity-Based Costing Methodology for Cost Savings in the EMOTE-TNK Study

Objective: To calculate financial savings resulting from early mobilization of patients with acute ischemic stroke receiving tenecteplase (TNK) in the Early Mobilization Outcomes with Tenecteplase Treatment in Acute Ischemic Stroke (EMOTE-TNK) safety and tolerability study. Patients and Methods: We used the Time-Driven Activity-Based Costing methodology to compare costs of 180 patients who had early mobilization, defined as occurring between 13 and 24 hours after thrombolysis, with those of patients who had conventional mobilization, defined as waiting 24 hours after thrombolysis. Patients were seen from February 13, 2021, through March 18, 2024. Results: We estimated that, by starting rehabilitation service evaluations earlier, the average duration of hospitalization was reduced by 0.5 days. Costs per patient in the conventional model were estimated to be $5000, whereas in the new model, it was $3750 (savings per patient, $1250). For our cohort of 180 patients, the total amount saved was $225,000 and 90 hospital days. Conclusion: The current study showed that, compared with conventional mobilization, early mobilization was associated with up to a 25% reduction in costs for patients with acute ischemic stroke receiving TNK. Future work should explore the downstream effects of early mobilization on discharge planning and other aspects of quality care.