IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0147364.html
   My bibliography  Save this article

The Expenditures for Academic Inpatient Care of Inflammatory Bowel Disease Patients Are Almost Double Compared with Average Academic Gastroenterology and Hepatology Cases and Not Fully Recovered by Diagnosis-Related Group (DRG) Proceeds

Author

Listed:
  • Daniel C Baumgart
  • Marie le Claire

Abstract

Background: Crohn’s disease (CD) and ulcerative colitis (UC) challenge economies worldwide. Detailed health economic data of DRG based academic inpatient care for inflammatory bowel disease (IBD) patients in Europe is unavailable. Methods: IBD was identified through ICD-10 K50 and K51 code groups. We took an actual costing approach, compared expenditures to G-DRG and non-DRG proceeds and performed detailed cost center and type accounting to identify coverage determinants. Results: Of all 3093 hospitalized cases at our department, 164 were CD and 157 UC inpatients in 2012. On average, they were 44.1 (CD 44.9 UC 43.3 all 58) years old, stayed 10.1 (CD 11.8 UC 8.4 vs. all 8) days, carried 5.8 (CD 6.4 UC 5.2 vs. all 6.8) secondary diagnoses, received 7.4 (CD 7.7 UC 7 vs. all 6.2) procedures, had a higher cost weight (CD 2.8 UC 2.4 vs. all 1.6) and required more intense nursing. Their care was more costly (means: total cost IBD 8477€ CD 9051€ UC 7903€ vs. all 5078€). However, expenditures were not fully recovered by DRG proceeds (means: IBD 7413€, CD 8441€, UC 6384€ vs all 4758€). We discovered substantial disease specific mismatches in cost centers and types and identified the medical ward personnel and materials budgets to be most imbalanced. Non-DRG proceeds were almost double (IBD 16.1% vs. all 8.2%), but did not balance deficits at total coverage analysis, that found medications (antimicrobials, biologics and blood products), medical materials (mostly endoscopy items) to contribute most to the deficit. Conclusions: DRGs challenge sophisticated IBD care.

Suggested Citation

  • Daniel C Baumgart & Marie le Claire, 2016. "The Expenditures for Academic Inpatient Care of Inflammatory Bowel Disease Patients Are Almost Double Compared with Average Academic Gastroenterology and Hepatology Cases and Not Fully Recovered by Di," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-15, January.
    • Handle: RePEc:plo:pone00:0147364
    DOI: 10.1371/journal.pone.0147364
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0147364
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0147364&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0147364?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jonas Schreyögg & Tom Stargardt & Oliver Tiemann & Reinhard Busse, 2006. "Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries," Health Care Management Science, Springer, vol. 9(3), pages 215-223, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Milstein, Ricarda & Schreyögg, Jonas, 2024. "The end of an era? Activity-based funding based on diagnosis-related groups: A review of payment reforms in the inpatient sector in 10 high-income countries," Health Policy, Elsevier, vol. 141(C).
    2. Lukas Kwietniewski & Mareike Heimeshoff & Jonas Schreyögg, 2017. "Estimation of a physician practice cost function," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(4), pages 481-494, May.
    3. Schreyögg, Jonas & Bäumler, Michael & Busse, Reinhard, 2009. "Balancing adoption and affordability of medical devices in Europe," Health Policy, Elsevier, vol. 92(2-3), pages 218-224, October.
    4. Gartner, Daniel & Kolisch, Rainer, 2014. "Scheduling the hospital-wide flow of elective patients," European Journal of Operational Research, Elsevier, vol. 233(3), pages 689-699.
    5. Andrew Street & Kirsi Vitikainen & Afsaneh Bjorvatn & Anne Hvenegaard, 2007. "Introducing activity-based financing: a review of experience in Australia, Denmark, Norway and Sweden," Working Papers 030cherp, Centre for Health Economics, University of York.
    6. Miraldo, M & Crea, G & Longo, R & Street, A, 2014. "Collusion in regulated pluralistic markets," Working Papers 15402, Imperial College, London, Imperial College Business School.
    7. Chrysanthos D. Christou & Eleni C. Athanasiadou & Andreas I. Tooulias & Argyrios Tzamalis & Georgios Tsoulfas, 2022. "The process of estimating the cost of surgery: Providing a practical framework for surgeons," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(4), pages 1926-1940, July.
    8. Raulinajtys-Grzybek, Monika, 2014. "Cost accounting models used for price-setting of health services: An international review," Health Policy, Elsevier, vol. 118(3), pages 341-353.
    9. Stefan Felder, 2009. "The variance of length of stay and the optimal DRG outlier payments," International Journal of Health Economics and Management, Springer, vol. 9(3), pages 279-289, September.
    10. Roberta Longo & Marisa Miraldo & Andrew Street, 2008. "Price regulation of pluralistic markets subject to provider collusion," Working Papers 045cherp, Centre for Health Economics, University of York.
    11. Hamada, Hironori & Sekimoto, Miho & Imanaka, Yuichi, 2012. "Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan," Health Policy, Elsevier, vol. 107(2), pages 194-201.
    12. Kristina Kast & Carl-Philipp Wachter & Oliver Schöffski & Martina Rimmele, 2021. "Economic evidence with respect to cost-effectiveness of the transitional care model among geriatric patients discharged from hospital to home: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 961-975, August.
    13. Matthew Grennan & Robert J. Town, 2020. "Regulating Innovation with Uncertain Quality: Information, Risk, and Access in Medical Devices," American Economic Review, American Economic Association, vol. 110(1), pages 120-161, January.
    14. Jérôme LARTIGAU, 2013. "Prospective Payment Systems And Evolution Of Management Control In French Hospitals: An Overview," Scientific Bulletin - Economic Sciences, University of Pitesti, vol. 12(2), pages 24-39.
    15. Vogl, Matthias, 2014. "Hospital financing: Calculating inpatient capital costs in Germany with a comparative view on operating costs and the English costing scheme," Health Policy, Elsevier, vol. 115(2), pages 141-151.
    16. Chris Bojke & Katja Grašič & Andrew Street, 2018. "How should hospital reimbursement be refined to support concentration of complex care services?," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 26-38, January.
    17. Machiel Westerdijk & Joost Zuurbier & Martijn Ludwig & Sarah Prins, 2012. "Defining care products to finance health care in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 203-221, April.
    18. Sutherland, Jason Murray & Walker, Jan, 2008. "Challenges of rehabilitation case mix measurement in Ontario hospitals," Health Policy, Elsevier, vol. 85(3), pages 336-348, March.
    19. Baxter, Pamela E. & Hewko, Sarah J. & Pfaff, Kathryn A. & Cleghorn, Laura & Cunningham, Barbara J. & Elston, Dawn & Cummings, Greta G., 2015. "Leaders’ experiences and perceptions implementing activity-based funding and pay-for-performance hospital funding models: A systematic review," Health Policy, Elsevier, vol. 119(8), pages 1096-1110.
    20. Giovanni Iuzzolino, 2008. "Demand and supply of hospital services. International trends," Questioni di Economia e Finanza (Occasional Papers) 27, Bank of Italy, Economic Research and International Relations Area.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0147364. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.