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SEER Registry Operations Cost Study From Feasibility to Full-Scale

SEER Registry Operations Cost Study From Feasibility to Full-Scale. NAACCR 2007 Annual Meeting Detroit, Michigan June 6, 2007 Amy L. Garson Program Analyst Surveillance Research Program Division of Cancer Control and Population Sciences. Acknowledgements. CSR, Inc. NCI/SEER Staff

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SEER Registry Operations Cost Study From Feasibility to Full-Scale

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  1. SEER Registry OperationsCost StudyFrom Feasibility to Full-Scale NAACCR 2007 Annual Meeting Detroit, Michigan June 6, 2007 Amy L. Garson Program Analyst Surveillance Research Program Division of Cancer Control and Population Sciences

  2. Acknowledgements • CSR, Inc. • NCI/SEER Staff • SEER Registry Staff

  3. SEER Cost Study • Feasibility Study (Phase I) – Overview • Feasibility to Full-Scale Study - Planned Refinements • Full Scale Study (Phase II) – Next Steps

  4. Purpose • Describe the total cost of operating the SEER central cancer registries • Make more informed planning and budgetary decisions • Assess operating efficiencies within each registry and identify areas for improvement • Provide a basis for dialogue between registries regarding cost effective practices

  5. Phase I - Goals • Develop methodology for collecting relevant accounting and operations data from SEER registries • Conduct pilot test with sample of SEER registries

  6. Phase I Questions of Interest • What are the sources of revenue funding each central registry? What are the central registry operating costs and staffing levels for each registry and specific registry functions? • How will staffing levels (full-time equivalents) and cost categories be affected by the introduction of new information technologies such as the SEER Data Management System (DMS) or E-Path? • What are the costs of performing central registry functions that are unique to SEER cancer registries? • Can costs associated with adding new or changing existing data elements be estimated?

  7. Phase I - Methodology • Planning • July—December, 2005 • Consensus process with SEER registries • Construct cost analysis framework • Implementation • December 2005—June 2006 • Develop cost analysis workbook • Pilot-test workbook at sample of SEER registries

  8. INPUTS Revenues Federal $ Non-Federal $ Staffing Position/Role Yrs Experience Education Budgeted/Actual Hours Salary/Fringe Funding Sources Level of Effort Other Direct Costs Equip/Repairs Materials/Supplies IT/Computing Repro/Printing Communications Travel Advertising Legal Fees Publications Conferences Memberships/Dues Postage/Shipping Consultants Contractors Diagram of the CostAnalysis Framework PROCESSES • 28 Registry Functions (Handouts) OUTPUTS • 2003 Cases CONTEXTUAL/ENVIRONMENTAL • Internal and External

  9. Data Collection--Cost Analysis Workbook • Microsoft Excel workbook • Revenues and Costs for Calendar Year 2005 • Pilot-tested the workbook: • Greater California • Iowa • Los Angeles • New Jersey • Seattle NOTE: Registries A – E in the following slides are listed arbitrarily; they do not follow the order listed above. • 3 Week data collection followed by 2-day field visits

  10. Phase I to Phase IIPlanned Refinements • Kinds of Information Gathered in Phase I; identification of areas for change • Caution should be exercised in drawing conclusions regarding actual data • Emphasis was on determining how the necessary accounting and operations data could be collected, and whether the resulting data could be used to address our questions

  11. NOTE: slide modified to exclude feasibility study pilot data Sources of Revenue Registry Operations, CY 2005 Percentage A B C D E Federal Funding Non-Federal Funding Registry

  12. NOTE: slide modified to exclude feasibility study pilot data SEER Registry Cost Share, CY 2005 Percentage A B C D E SEER Non-Federal Registry

  13. NOTE: slide modified to exclude feasibility study pilot data Total Cost Per Case (Direct + Indirect) $162 $85 2003 Cases $148 $177 $292 A B C D E Registry

  14. NOTE: slide modified to exclude feasibility study pilot data Total Cost Per Case (Direct + Indirect), CY 2005 $292 Dollars $177 $162 $148 $85 A B C D E Total Direct Costs Indirect Costs Registry

  15. NOTE: slide modified to exclude feasibility study pilot data Composition of Costs, CY 2005 $3.9M $5.6M $13.0M $4.8M $4.2M Percentage A B C D E Salaries & Wages Fringe Benefits Other Direct Costs Indirect Costs Registry

  16. NOTE: slide modified to exclude feasibility study pilot data FTEs EXPENDED PRODUCTION FUNCTIONS Function # A B C D E Total Function 1 Case Finding 2 E-path Case Finding 3 Abstracting/Coding 4 Data Exchange Activities 5 Case Receipt and Loading 6 Editing of Cases and Reports 7 Consolidation 8 Active Follow-up Passive Follow-up Record 9 Linkages: Registry Ops Record Linkages - Developmental 10 Research/Data Quality 11 Follow-back 12 Death Clearance 23 Calls for Data Submissions Subtotal Production

  17. ADMINISTRATION & MANAGEMENT Function # Function C Administration and Management 13 Personnel Recruitment and Management 14 Subtotal Admin/Mgt INFORMATION TECHNOLOGY IT - Basic Infrastructure 15 IT - Innovative Applications 16 Subtotal IT QUALITY IMPROVEMENT Local QC/QI Activities 17 NCI-SEER QC/QI Audit Activities 18 NCI-SEER QC/QI Activities - All Years 19 NCI QC/QI Special Projects 20 Subtotal QC/QI A B D E Total A B C D E Total A B C D E Total NOTE: slide modified to exclude feasibility study pilot data

  18. TRAINING Function # Function Attendance at Training 21 Conducting Teaching and Training, Sharing Expertise 22 Subtotal Training RESEARCH RELATED Rapid Case Ascertainment 24 Research Activities 26 Reports and Data Requests 28 Subtotal Research Related GRAND TOTAL Note: Functions #25 (Rapid Response Surveillance Studies - RRSS) and #27 (Tissue Discard) excluded A B C D E Total A B C D E Total NOTE: slide modified to exclude feasibility study pilot data

  19. Definition Revisions • 28 original function definitions generally met needs • 3 Main changes - 31 functions now proposed • ‘Research Activities’ to ‘Research Support’ -renamed and revised to more clearly delineate central registry staff roles and responsibilities • Administration and Management – added a new function to help distinguish lower level vs. higher level activities • Training – added new category for ‘On-The-Job Training - separated internal vs. external training

  20. NOTE: slide modified to exclude feasibility study pilot data Staffing - Years of Experience Total Persons = N A B C D E Up to 1 Year 1 - 5 Years 5 - 10 Years 10 - 20 Years Greater Than 20 Years Persons Per Registry Percentage Registry

  21. Summary of Major Modifications Data Collection • Annual in 15 SEER registries • SEER Operating Cycle (Nov. 1 – Oct. 31) Output Measures • Overall • Function-specific (e.g., abstracting/coding, active fu, death clearance) Web-Based Data Collection and Analysis Tool • Capture info on ‘infrequent/one-time’ large expenditures • Accommodate funds paid external to registry • Staffing data on turnover/retention • Registry profile data to be incorporated • Actual salary/fringe expenditures • Better accommodate data collection and analysis for registries with regional subcontracts Function Definition Revisions • Research • Administrative Management • Training Other Direct Costs • Revise cost categories

  22. Phase II – Next Steps • What are the central registry operating costs and staffing levels for each registry and specific registry functions? • How will costs and staffing levels change over?

  23. Timeline of Activities • Planning: June—December, 2007 • Reconvene SEER Registry Operations Cost Study (ROCS) Workgroup • Develop Web-Based Data Collection and Analysis Tool • Implementation: December 2007—May 2008 • Protocol/Training • Data Collection and Analysis

  24. Questions/Feedback • Contact: garsona@mail.nih.gov

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