Direct patient treatment costs in the Allergology Service of a University Hospital

Abstract

Health resources are limited and consequently real cost generators must be identified to optimize resources. In the present article, we describe the structure of the Allergy Unit of the University Hospital Virgen de la Arrixaca in Murcia (Spain), the health area in which allergic patients are attended, and the final healthcare products generated. Based on the 2004-2005 budget, variable costing was used to calculate the costs of the healthcare products generated (first visits, subsequent visits, and diverse laboratory tests) by two of the three homogeneous functional groups (HFG), i.e., HFG of the ambulatory service and HFG of complementary tests. The following conclusions can be drawn: 1) the current system of variable costing provides information, which should be useful to health professionals; 2) the real cost generators in the microcosm of daily clinical practice should be identified to allow resource reallocation; 3) the costing system used enables modifications to be made that allow decision making on optimal use of the budget; 4) clinical management and complementary tests should go hand in hand with a view to optimizing resources.

Non-compliance with appointments amongst patients attending an Allergology Clinic, after implementation of an improvement plan

“…Another important aspect to be considered is the economic cost of non-compliance. Using an approximate calculation of costs at our clinic by means of analytical accountancy, as described in a recent study 62 , the cost of the doctor's time is 47.40 1 at a first visit and 31.60 1 at subsequent visits. This means that the cost of missed appointments stands at 85,256.80 1.…”

Proposal for relative units of value (RUV) for use in allergy examinations

“…Recently, using activity indicators and the costs structure from the first semester of 2005, we estimated the costs of a first and a second visit for the patients attended during that period in our Department 5 . Although we used previously proposed RUV for the calculation of the costs of supplementary examinations, we were aware that it was necessary to update them for the various diagnostic techniques used in Allergology.…”