Prospektive Kostenerfassung einer internistischen Intensivstation

The daily therapy-cost for all patients amounted to 1,195 Euro and the cost per TISS-28 point came to 54 Euro with an average of 22 TISS-28 points per day. The detected big range of the TISS-28 point costs and of the TISS-28 points per day reveals that costing by means of this scoring system only does not allow for generalized statements and should always be questioned critically. With respect to the daily therapy-cost, for the aspect “active treatment” only, significant differences could be determined (ICU daily cost per patient with “active treatment” 1,257 Euro, 987 Euro per patient with “non-active treatment”). Labour costs accounted for the major share of total costs for all patients of the intensive care unit at 39%, which was expected. The remaining cost-percentages breakdown had diagnostic measures at 18%, pharmaceuticals at 14%, consumables at 11%, interventions at 10%, and electricity and maintenance at 8%. During the observation period, total costs of hospitalization were 11,087,553 Euro. The largest source of this cost was the hospital ward (6,351,772 Euro; 57%) vs. intensive care unit. Effective costs per survivor (ECPS) accounted for 13,756 Euro on average. Patients that were admitted with cardiac-circulation arrest generated a cost of 30,123 Euro per length of stay (LOS) in the ICU and 47,994 Euro to the overall hospital LOS, thus having the highest ECPS followed by patients with the admission diagnosis of “valvular diseases” (ECPS of ICU 12,514 Euro, ECPS of the hospital stay 27,712 Euro) and “other pulmonary diseases” as pneumonia or COPD (ECPS of ICU 11,531 Euro, ECPS of the hospital stay 25,139 Euro). In the future, the optimal allocation of limited resources in health care system is one of the main challenges for physicians. In order to get a basic picture of “ideal” resource allocation knowledge of expenses and cost should be thought of as “input” while outcomes and benefits should be thought of as “output”. The research presented in this paper shall make a contribution to estimating the “input-side“ of an internal ICU to provide an opportunity for further cost-benefit / cost-effectiveness or cost-efficiency analysis, thereby setting up a funded basis for political decisions in health care on a resource allocation that is optimal and patient-suitable.Abbreviations:COPDChronic obstructive pulmonary diseaseECPSEffective cost per survivorICUIntensive care unitLOSLength of stayTISSTherapeutic Intervention Scoring System

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2007

Author dc:creator

• Bode, Kirsten Britta

Contributors dc:contributor

• Janssens, Uwe

• info:eu-repo/classification/ddc/610
• Kostenkalkulation
• Kostenkategorien
• Gesundheitssystem
• Intensivmedizin
• DRG
• TISS-28
• Liegedauer
• Ökonomische Evaluation
• Medizin
• Cost-calculation
• Cost-categories
• Health care system
• Intensive care
• Length of stay
• Economic evaluation

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-114323%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A52081