Costing Hospital Surgery Services: The Method Matters

Mercier, Grégoire; Naro, Gérald

doi:10.1371/journal.pone.0097290

Cited by 56 publications

(58 citation statements)

References 28 publications

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“…However, it is challenging to accurately estimate costs of hospital services. Studies show that different costing methods could result in different costs for a given service …”

Section: Calculating Costmentioning

confidence: 99%

ERAS—Value based surgery

Ljungqvist

Thanh

Nelson

2017

Journal of Surgical Oncology

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This paper reviews implementation of ERAS and its financial implications. Literature on clinical outcomes and financial implications were reviewed. Reports from many different surgery types shows that implementation of ERAS reduces complications and shortens hospital stay. These improvements have major impacts on reducing the cost of care even when costs for implementation, and investment in time for personnel and training is accounted for. The conclusion is that ERAS is an excellent example of value based surgery.

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“…However, it is challenging to accurately estimate costs of hospital services. Studies show that different costing methods could result in different costs for a given service …”

Section: Calculating Costmentioning

confidence: 99%

ERAS—Value based surgery

Ljungqvist

Thanh

Nelson

2017

Journal of Surgical Oncology

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“…Therefore, neither the full top-down method nor the proposed mixed method accurately measures these variables. As suggested by Mercier et al, the introduction of time-driven activity-based costing will provide a more accurate weighting, with minimal adjustment, while offsetting the non-consideration of operation time variation in top-down methods [27]. Moreover, considering indirect costs, such as overhead and capital, would contribute to a more comprehensive cost estimation for hospital services [28].…”

Section: Discussionmentioning

confidence: 99%

Mixed method versus full top-down microcosting for organ recovery cost assessment in a French hospital group

et al. 2016

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BackgroundThe costing method used can change the results of economic evaluations. Choosing the appropriate method to assess the cost of organ recovery is an issue of considerable interest to health economists, hospitals, financial managers and policy makers in most developed countries.ObjectivesThe main objective of this study was to compare a mixed method, combining top-down microcosting and bottom-up microcosting versus full top-down microcosting to assess the cost of organ recovery in a French hospital group. The secondary objective was to describe the cost of kidney, liver and pancreas recovery from French databases using the mixed method.MethodsThe resources consumed for each donor were identified and valued using the proposed mixed method and compared to the full top-down microcosting approach. Data on kidney, liver and pancreas recovery were collected from a medico-administrative French database for the years 2010 and 2011. Related cost data were recovered from the hospital cost accounting system database for 2010 and 2011. Statistical significance was evaluated at P < 0.05.ResultsAll the median costs for organ recovery differ significantly between the two costing methods (non-parametric test method; P < 0.01). Using the mixed method, the median cost for recovering kidneys was found to be €5155, liver recovery was €2528 and pancreas recovery was €1911. Using the full top-down microcosting method, median costs were found to be 21–36% lower than with the mixed method.ConclusionThe mixed method proposed appears to be a trade-off between feasibility and accuracy for the identification and valuation of cost components when calculating the cost of organ recovery in comparison to the full top-down microcosting approach.Electronic supplementary materialThe online version of this article (doi:10.1186/s13561-016-0133-3) contains supplementary material, which is available to authorized users.

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“…Such research often use reference costs or top-down approaches to determine the cost of a TKR. TDABC is viewed to provide more accurate and transparent cost estimates that allow efficiency and cost containment to be evaluated in greater detail than traditional costing methods [15]. Furthermore this approach distinguishes the costs of non-homogenous patient groups more effectively than top down methods because it is based on patient level analysis [11,15].…”

Section: Introductionmentioning

confidence: 99%

“…TDABC is viewed to provide more accurate and transparent cost estimates that allow efficiency and cost containment to be evaluated in greater detail than traditional costing methods [15]. Furthermore this approach distinguishes the costs of non-homogenous patient groups more effectively than top down methods because it is based on patient level analysis [11,15]. However, the time consuming and often costly nature of this method could explain why health services choose less accurate top-down methods which are cheaper and easier to implement [16].…”

Section: Introductionmentioning

confidence: 99%