Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model
PRINCIPLES: Reimbursement systems have difficulties depicting the actual cost of burn treatment, leaving care providers with a significant financial burden. Our aim was to establish a simple and accurate reimbursement model compatible with prospective payment systems. METHODS: A tot...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2015-11-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2102 |
| _version_ | 1798003771649818624 |
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| author | Tarun Mehra Virve Koljonen Burkhardt Seifert Jörk Volbracht Pietro Giovanoli Jan Plock Rudolf Maria Moos |
| author_facet | Tarun Mehra Virve Koljonen Burkhardt Seifert Jörk Volbracht Pietro Giovanoli Jan Plock Rudolf Maria Moos |
| author_sort | Tarun Mehra |
| collection | DOAJ |
| description |
PRINCIPLES: Reimbursement systems have difficulties depicting the actual cost of burn treatment, leaving care providers with a significant financial burden. Our aim was to establish a simple and accurate reimbursement model compatible with prospective payment systems.
METHODS: A total of 370 966 electronic medical records of patients discharged in 2012 to 2013 from Swiss university hospitals were reviewed. A total of 828 cases of burns including 109 cases of severe burns were retained. Costs, revenues and earnings for severe and nonsevere burns were analysed and a linear regression model predicting total inpatient treatment costs was established.
RESULTS: The median total costs per case for severe burns was tenfold higher than for nonsevere burns (179 949 CHF [167 353 EUR] vs 11 312 CHF [10 520 EUR], interquartile ranges 96 782–328 618 CHF vs 4 874–27 783 CHF, p <0.001). The median of earnings per case for nonsevere burns was 588 CHF (547 EUR) (interquartile range –6 720 – 5 354 CHF) whereas severe burns incurred a large financial loss to care providers, with median earnings of –33 178 CHF (30 856 EUR) (interquartile range –95 533 – 23 662 CHF). Differences were highly significant (p <0.001). Our linear regression model predicting total costs per case with length of stay (LOS) as independent variable had an adjusted R2of 0.67 (p <0.001 for LOS).
CONCLUSIONS: Severe burns are systematically underfunded within the Swiss reimbursement system. Flat-rate DRG-based refunds poorly reflect the actual treatment costs. In conclusion, we suggest a reimbursement model based on a per diem rate for treatment of severe burns.
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| first_indexed | 2024-04-11T12:13:12Z |
| format | Article |
| id | doaj.art-ab8601291f564522a22721597de51a79 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T12:13:12Z |
| publishDate | 2015-11-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-ab8601291f564522a22721597de51a792022-12-22T04:24:32ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972015-11-01145474810.4414/smw.2015.14217Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement modelTarun MehraVirve KoljonenBurkhardt SeifertJörk VolbrachtPietro GiovanoliJan PlockRudolf Maria Moos PRINCIPLES: Reimbursement systems have difficulties depicting the actual cost of burn treatment, leaving care providers with a significant financial burden. Our aim was to establish a simple and accurate reimbursement model compatible with prospective payment systems. METHODS: A total of 370 966 electronic medical records of patients discharged in 2012 to 2013 from Swiss university hospitals were reviewed. A total of 828 cases of burns including 109 cases of severe burns were retained. Costs, revenues and earnings for severe and nonsevere burns were analysed and a linear regression model predicting total inpatient treatment costs was established. RESULTS: The median total costs per case for severe burns was tenfold higher than for nonsevere burns (179 949 CHF [167 353 EUR] vs 11 312 CHF [10 520 EUR], interquartile ranges 96 782–328 618 CHF vs 4 874–27 783 CHF, p <0.001). The median of earnings per case for nonsevere burns was 588 CHF (547 EUR) (interquartile range –6 720 – 5 354 CHF) whereas severe burns incurred a large financial loss to care providers, with median earnings of –33 178 CHF (30 856 EUR) (interquartile range –95 533 – 23 662 CHF). Differences were highly significant (p <0.001). Our linear regression model predicting total costs per case with length of stay (LOS) as independent variable had an adjusted R2of 0.67 (p <0.001 for LOS). CONCLUSIONS: Severe burns are systematically underfunded within the Swiss reimbursement system. Flat-rate DRG-based refunds poorly reflect the actual treatment costs. In conclusion, we suggest a reimbursement model based on a per diem rate for treatment of severe burns. https://www.smw.ch/index.php/smw/article/view/2102Costprospective payment systemSwissDRGearningseconomics |
| spellingShingle | Tarun Mehra Virve Koljonen Burkhardt Seifert Jörk Volbracht Pietro Giovanoli Jan Plock Rudolf Maria Moos Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model Swiss Medical Weekly Cost prospective payment system SwissDRG earnings economics |
| title | Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model |
| title_full | Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model |
| title_fullStr | Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model |
| title_full_unstemmed | Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model |
| title_short | Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model |
| title_sort | total inpatient treatment costs in patients with severe burns towards a more accurate reimbursement model |
| topic | Cost prospective payment system SwissDRG earnings economics |
| url | https://www.smw.ch/index.php/smw/article/view/2102 |
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