A micro-costing approach to estimating hospital costs for appendectomy in a Cross-European context

Schreyögg, Jonas

doi:10.1002/hec.1323

Cited by 37 publications

(29 citation statements)

References 27 publications

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“…Although associated with shorter stays compared to open appendectomy, laparoscopic approach is more frequently linked with significantly higher costs in other studies [12,13,14]. However, in another studies, these higher costs may be justifiable, as laparoscopy is associated with lower rates of wound infection [9,15,16].…”

Section: Discussionmentioning

confidence: 99%

Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy

et al. 2015

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PurposeThe implementation of the Korean diagnosis-related groups (DRG) payment system has been recently introduced in selected several diseases including appendectomy in Korea. Here, we report the early outcomes with regard to clinical aspects and medical costs of the Korean DRG system for appendectomies in Seoul Metropolitan Government - Seoul National University Boramae Medical Center throughout comparing before and after introduction of DRG system.MethodsThe DRG system was applied since January 2013 at our institute. After the DRG system, we strategically designed and applied our algorithm for the treatment of probable appendicitis. We reviewed the patients who were treated with a procedure of appendectomy for probable appendicitis between July 2012 and June 2013, divided two groups based on before and after the application of DRG system, and compared clinical outcomes and medical costs.ResultsTotal 416 patients were included (204 patients vs. 212 patients in the group before vs. after DRG). Shorter hospital stays (2.98 ± 1.77 days vs. 3.82 ± 1.84 days, P < 0.001) were found in the group after DRG. Otherwise, there were no significant differences in the perioperative outcomes and medical costs including costs for first hospitalization and operation, costs for follow-up after discharge, frequency of visits of out-patient's clinic or Emergency Department or rehospitalization.ConclusionIn the Korean DRG system for appendectomy, there were no significant differences in perioperative outcomes and medical costs, except shorter hospital stay. Further studies should be continued to evaluate the current Korean DRG system for appendectomy and further modifications and supplementations are needed in the future.

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Section: Discussionmentioning

confidence: 99%

Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy

et al. 2015

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“…Micro-costing refers to cost accounting on a small scale and is an ideal method to capture resource usage. 9 Given the availability of retrospective data, it was not feasible to use the micro-costing technique. We also did not include intraoperative time as a variable.…”

Section: Discussionmentioning

confidence: 99%

Cost‐Identification Analysis of Total Laryngectomy

Dedhia

Weissfeld

Saul

et al. 2011

Otolaryngol.--head neck surg.

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Objectives To understand the contribution of intraoperative and postoperative hospital costs to total hospital costs, examine the costs associated with specific hospital services in the postoperative period, and recognize the impact of patient factors on hospital costs. Study Design Case series with chart review. Setting Large tertiary care teaching hospital system. Subjects and Methods Using the Pittsburgh Head and Neck Organ-Specific Database, 119 patients were identified as having total laryngectomy with bilateral selective neck dissection and primary closure from 1999 to 2009. Cost data were obtained for 112 patients. Costs include fixed and variable costs, adjusted to 2010 US dollars using the Consumer Price Index. Results Mean total hospital costs were $29 563 (range, $10 915 to $120 345). Operating room costs averaged 24% of total hospital costs, whereas room charges, respiratory therapy, laboratory, pharmacy, and radiology accounted for 38%, 14%, 8%, 7%, and 3%, respectively. Median length of stay was 9 days (range, 6–43), and median Charlson comorbidity index score was 8 (2–16). Patients with ≥1 day in the intensive care unit had significantly higher hospital costs ($46 831 vs $24 601, P < .01). The authors found no significant cost differences with stratification based on previous radiation therapy ($27 598 vs $29 915 with no prior radiation, P = .62) or hospital readmission within 30 days ($29 483 vs $29 609 without readmission, P = .97). Conclusion This is one of few studies in surgery and the first in otolaryngology to analyze hospital costs for a relatively standardized procedure. Further work will include cost analysis from multiple centers with investigation of global cost drivers.

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“…Microcosting has been utilized in other contexts, such as comparing two surgical procedures in the same center [16] and in in-depth cost estimations of screening techniques for use in cost-effectiveness analyses [17,18]. In oncology, microcosting has been used to assess the cost of sentinel lymph node detection versus axillary lymphadenectomy in early breast cancer [19], the cost of trastuzumab in the Breast Cancer International Research Group 006 trial [20], the comparative costs of diffuse large B-cell lymphoma therapy in a Canadian study [21], and the comparative costs of postoperative complications after inguinal lymph node dissection in melanoma patients [22].…”

Section: Methodsmentioning

confidence: 99%

Comparison of Quick Diagnosis Units and Conventional Hospitalization for the Diagnosis of Cancer in Spain: A Descriptive Cohort Study

Bosch

Moreno²,

Ríos³

et al. 2012

Oncology

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Objective: Quick diagnosis units (QDUs) in Spain provide patients with severe disease who would normally require hospitalization with the prompt and effective diagnosis they deserve. We compared the value and cost of a QDU and of conventional hospitalization in assessing patients with cancer. Methods: In a descriptive cohort study, 169 patients with a final diagnosis of cancer were prospectively evaluated between November 2008 and April 2010. We also analyzed a retrospective cohort of 53 randomly selected patients with neoplasia hospitalized during this period. In addition to the variables time to diagnosis and length of stay, we compared the costs of both models using microcosting techniques. Results: Colorectal cancer was the commonest cancer (26%). QDU patients were younger than hospitalized patients (68.3 vs. 74.7 years; p < 0.05), and there were also significant differences with respect to the source of referral (p < 0.00001) and destination (p < 0.00001), but not regarding diagnosis (p > 0.34), reason for consultation (p > 0.26) and time to diagnosis/length of stay (Wilcoxon rank sum test, p > 0.05). The mean costs for hospitalization were EUR 4,059.37 compared with EUR 601.84 in the QDU. Conclusion: For diagnostic purposes, cancer patients can be managed similarly in a QDU or in in-hospital settings, but the QDU model seems to incur fewer costs.

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A micro-costing approach to estimating hospital costs for appendectomy in a Cross-European context

Cited by 37 publications

References 27 publications

Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy

Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy

Cost‐Identification Analysis of Total Laryngectomy

Comparison of Quick Diagnosis Units and Conventional Hospitalization for the Diagnosis of Cancer in Spain: A Descriptive Cohort Study

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