Paying a premium : How patient complexity affects costs and profit margins. Discussion.
Annual Scientific Session of the Southern Surgical Association. Palm Beach, FL, USA, 1998/12/06.
Objective and Background Tertiary medical centers continue to be under extreme pressure to deliver high-complexity care, but paradoxically there is considerable pressure within these institutions to reduce their emphasis on tertiary care and refocus their efforts to develop a more community-like practice.
The genesis of this pressure is the perceived profitability of routine surgical activity when compared with more complex care.
The purpose of this study is to assess how the total cost and profit (loss) margin can vary for an entire trauma service.
The authors also evaluate payments for specific trauma-related diagnostic-related groups (DRGs) and analyze how hospital margins were affected based on mortality outcome.
Materials and Methods The authors analyzed the actual cost of all trauma discharges (n=692) at their level I trauma center for fiscal year 1997.
Data were obtained from the trauma registry and the hospital cost accounting system.
Total cost was defined as the sum of the variable, fixed, and indirect costs associated with each patient.
Margin was defined as expected payments minus total cost.
The entire population and all DRGs with 10 or more patients were stratified based on survival outcome, Injury Severity Score, insurance status, and length of stay.
The mean total costs for survivors and nonsurvivors within these various categories and their margins were evaluated. (...)
Mots-clés Pascal : Service hospitalier, Traumatologie, Analyse avantage coût, Mortalité, Soin, Economie, Homme
Mots-clés Pascal anglais : Hospital ward, Traumatology, Cost benefit analysis, Mortality, Care, Economy, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0334732
Code Inist : 002B30A04B. Création : 16/11/1999.