Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

Abstract

In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p \ 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of €1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

CIRSE Clinical Practice Manual

“…If not already established, IRs should strive to attain admitting rights, so that patients may be accepted via direct referral from family practitioners and consultants from other hospitals. Ideally, all IR patients would be admitted to a specific IR ward [ 94 ], as there is a benefit from “concentrating” patients with similar care needs in the same ward. In the absence of a dedicated IR ward, ideally, a set number of beds should be “protected” for elective IR admissions.…”

“…In hospital systems where the “money follows the patient”, the hospital will see the benefit of offering IRs the ability to receive and admit their own patients. Simonetti et al documented the financial benefits to the institution derived, in part, from the shorter admission pathway and length of stay [ 94 ].…”