BackgroundLittle is known about diagnostic work-ups or the costs of diagnosing dementia in specialized care. Here, we analyzed the costs of diagnosing dementia according to specific dementia disorders.MethodsA prospective descriptive design was used to analyze the cost of diagnosing dementia for 120 patients with suspected dementia at a German memory clinic. The duration of clinical consultations and use of technical procedures were recorded by the memory clinic staff. To detect cost drivers, a multiple linear regression model was used.ResultsOf patients with suspected dementia, 44% were diagnosed with dementia. The total cost per patient and diagnostic process amounted to 501 € across all patients and 659 € for patients who were diagnosed with dementia. The costs varied between 649 € for patients with Alzheimer’s disease, 662 € for patients with vascular or mixed dementia, and 705 € for patients with unspecific dementia. A final diagnosis of dementia was the only factor that was significantly associated with the diagnostic cost (b = 356, CI– 182, CI+ 531, p = 0.001).ConclusionThe high range of costs reflects differences in diagnostic demands depending on the etiology of dementia. This variation needs to be transferred into reimbursement. Further studies are needed to assess the influence of the type of cognitive impairment and of the setting on diagnostic costs.Electronic supplementary materialThe online version of this article (doi:10.1186/s13195-017-0290-6) contains supplementary material, which is available to authorized users.
Health Care systems are facing several challenges. The lack of resources, such as health workers, costing and financing are open and urgent questions in Health Care Systems. Tools from HRManagement (e.g. the Workload Indicator of Staffing Need (WISN) – method, WHO - HR-Management Tool) and Cost-Accounting can help to improve current financing and further develop healthcare reimbursement systems, such as DRG-Systems. Based on empirical data and interviews with healthcare professionals from multiple healthcare institutions in Kyrgyzstan the WISN method was applied to calculate human resource needs in a new perinatal health centre in Bishkek, Kyrgyzstan. The results of the analysis show that it is possible to calculate the required personal resources using the WISN method. Additionally, WISN can be used to calculate personnel costs. The results also show that in combination with material costs, e.g. from a DRG – Cost – Matrix, such as the G-DRG-Report Browser, it is possible to calculate the total costs of healthcare services and to use this as the basis for the reimbursement system. WISN in combination with additional Cost-Accounting systems is a good way to calculate the total costs for an intervention in a healthcare institution, e.g. a hospital. These tools can help to make financing in healthcare more transparent and efficient.
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