Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial
BACKGROUND Continuous EEG (cEEG) is increasingly used in critically ill patients, but it is more resource-intensive than routine EEG (rEEG). In the US, cEEG generates increased hospitalisation charges. This study analysed hospital-related reimbursement for participants in a Swiss multice...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2021-03-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2976 |
| _version_ | 1826995634546147328 |
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| author | Valentina Urbano Jan Novy Kaspar Schindler Stephan Rüegg Vincent Alvarez Frédéric Zubler Mauro Oddo Jong Woo Lee Andrea O. Rossetti |
| author_facet | Valentina Urbano Jan Novy Kaspar Schindler Stephan Rüegg Vincent Alvarez Frédéric Zubler Mauro Oddo Jong Woo Lee Andrea O. Rossetti |
| author_sort | Valentina Urbano |
| collection | DOAJ |
| description |
BACKGROUND
Continuous EEG (cEEG) is increasingly used in critically ill patients, but it is more resource-intensive than routine EEG (rEEG). In the US, cEEG generates increased hospitalisation charges. This study analysed hospital-related reimbursement for participants in a Swiss multicentre randomised controlled trial that assessed the relationship of cEEG versus repeated rEEG with outcome.
METHODS
We used data of the CERTA study (NCT03129438), including demographics, clinical variables and reimbursement for acute hospitalisations after the Swiss Diagnosis Related Groups billing system. In addition to a comparison between EEG intervention groups, we explored correlations with several clinical variables, using uni- and multivariate analyses.
RESULTS
In total, 366 adults were analysed (184 cEEG, 182 rEEG); 123 (33.6%) were women, mean age was 63.8 years (± 15). Median hospitalisation reimbursement was comparable across EEG groups in univariate analysis: cEEG CHF 89,631 (interquartile range [IQR] 45,635–159,994); rEEG CHF 73,017 (IQR 43,031–158,565); p = 0.432. However, multivariate regression disclosed that increasing reimbursement mostly correlated with longer acute hospitalisation (p <0.001), but also with cEEG (p = 0.019) and lack of seizure / status epilepticus detection (a surrogate of survival, p = 0.036).
CONCLUSION
In a Swiss Diagnosis Related Groups billing system applied to critically ill adults, reimbursement largely depends on duration of acute hospital stay, whereas cEEG and lack of seizure/ status epilepticus detection also contribute to the bill. This differs from the USA, where charges are directly increased by cEEG.
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| first_indexed | 2024-04-11T04:27:05Z |
| format | Article |
| id | doaj.art-7b81f105eebe4775a9782989128a24ab |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2025-02-18T09:35:20Z |
| publishDate | 2021-03-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-7b81f105eebe4775a9782989128a24ab2024-11-02T17:49:17ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972021-03-01151111210.4414/smw.2021.20477Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trialValentina Urbano0Jan Novy1Kaspar Schindler2Stephan Rüegg3Vincent Alvarez4Frédéric Zubler5Mauro Oddo6Jong Woo Lee7Andrea O. Rossetti8Department of Neurology, Lausanne University Hospital and University of Lausanne, SwitzerlandDepartment of Neurology, Lausanne University Hospital and University of Lausanne, SwitzerlandSleep-Wake-Epilepsy-Centre, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, SwitzerlandDepartment of Neurology, University Hospital Basel and University of Basel, SwitzerlandDepartment of Neurology, Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology, Hôpital du Valais, Sion, SwitzerlandSleep-Wake-Epilepsy-Centre, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, SwitzerlandDepartment of Intensive Care Medicine, Lausanne University Hospital and University of Lausanne, SwitzerlandDepartment of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USADepartment of Neurology, Lausanne University Hospital and University of Lausanne, Switzerland BACKGROUND Continuous EEG (cEEG) is increasingly used in critically ill patients, but it is more resource-intensive than routine EEG (rEEG). In the US, cEEG generates increased hospitalisation charges. This study analysed hospital-related reimbursement for participants in a Swiss multicentre randomised controlled trial that assessed the relationship of cEEG versus repeated rEEG with outcome. METHODS We used data of the CERTA study (NCT03129438), including demographics, clinical variables and reimbursement for acute hospitalisations after the Swiss Diagnosis Related Groups billing system. In addition to a comparison between EEG intervention groups, we explored correlations with several clinical variables, using uni- and multivariate analyses. RESULTS In total, 366 adults were analysed (184 cEEG, 182 rEEG); 123 (33.6%) were women, mean age was 63.8 years (± 15). Median hospitalisation reimbursement was comparable across EEG groups in univariate analysis: cEEG CHF 89,631 (interquartile range [IQR] 45,635–159,994); rEEG CHF 73,017 (IQR 43,031–158,565); p = 0.432. However, multivariate regression disclosed that increasing reimbursement mostly correlated with longer acute hospitalisation (p <0.001), but also with cEEG (p = 0.019) and lack of seizure / status epilepticus detection (a surrogate of survival, p = 0.036). CONCLUSION In a Swiss Diagnosis Related Groups billing system applied to critically ill adults, reimbursement largely depends on duration of acute hospital stay, whereas cEEG and lack of seizure/ status epilepticus detection also contribute to the bill. This differs from the USA, where charges are directly increased by cEEG. https://www.smw.ch/index.php/smw/article/view/2976impaired consciousnesscostscritically-illmonitoringoutcome |
| spellingShingle | Valentina Urbano Jan Novy Kaspar Schindler Stephan Rüegg Vincent Alvarez Frédéric Zubler Mauro Oddo Jong Woo Lee Andrea O. Rossetti Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial Swiss Medical Weekly impaired consciousness costs critically-ill monitoring outcome |
| title | Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial |
| title_full | Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial |
| title_fullStr | Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial |
| title_full_unstemmed | Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial |
| title_short | Continuous versus routine EEG in critically ill adults: reimbursement analysis of a randomised trial |
| title_sort | continuous versus routine eeg in critically ill adults reimbursement analysis of a randomised trial |
| topic | impaired consciousness costs critically-ill monitoring outcome |
| url | https://www.smw.ch/index.php/smw/article/view/2976 |
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