Evidence map›Paper›PMID 40557299›Full record

ArticlePlastic and reconstructive surgery. Global open2025

Optimizing Costs in Plastic Surgery: A Systematic Review of Time-driven Activity-based Costing Applications.

Emily L Isch, Gabrielle Kozlowski, D Mitchell Self, Theodore E Habarth-Morales, Sydney Somers, Ahilan Sivaganesan, David Kim, Heather McMahon, Andrew Newman, Matthew Jenkins

Abstract read
In one paragraph

Article in Plastic and reconstructive surgery. Global open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Emily L IschFrom the Division of Plastic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA.
Gabrielle KozlowskiDepartment of Surgery, Thomas Jefferson University, Philadelphia, PA.
D Mitchell SelfDepartment of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA.
Theodore E Habarth-MoralesDepartment of Surgery, Thomas Jefferson University, Philadelphia, PA.
Sydney SomersDepartment of Surgery, Thomas Jefferson University, Philadelphia, PA.
Ahilan SivaganesanDepartment of Spine Surgery, Hospital for Special Surgery, Naples, FL.
David KimFrom the Division of Plastic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA.
Heather McMahonFrom the Division of Plastic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA.
Andrew NewmanFrom the Division of Plastic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA.
Matthew JenkinsFrom the Division of Plastic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The rising complexity and cost of healthcare in plastic surgery, particularly in resource-intensive procedures like free flap and breast reconstruction, pose significant financial challenges. Time-driven activity-based costing (TDABC) offers a method to accurately assess these costs by mapping each step of the care cycle based on time and resources consumed. Although TDABC has been utilized in high-cost fields such as neurosurgery and spine surgery, its application in plastic surgery remains underexplored. This systematic review evaluates the literature on TDABC use in plastic surgery to identify key cost drivers and propose strategies for cost-efficiency. Methods: A systematic review was conducted on studies applying TDABC, activity-based costing, and cost-to-charge ratio in plastic surgery, sourced from PubMed. Inclusion criteria focused on peer-reviewed studies from the last decade assessing costing strategies in aesthetic and reconstructive plastic surgery, resulting in 17 studies that provided empirical data on cost drivers and resource allocation. Results: Operating room time, staffing, and postoperative care are identified as primary cost contributors in complex reconstructive surgery, with TDABC highlighting inefficiencies such as prolonged operating room time and unnecessary intensive care unit stays. Cost-saving opportunities were found in optimizing postoperative care and reallocating tasks to lower-cost personnel. Conclusions: TDABC provides a framework for cost optimization in plastic surgery by offering granular insights into resource utilization, allowing for targeted interventions that reduce expenses without compromising care quality. Future research should explore the application of TDABC to cosmetic procedures and assess its long-term cost-effectiveness in plastic surgery.

Identifiers

PMID40557299
PMCPMC12187278

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.