A cost analysis of treating hip fracture patients with a bottom-up perspective
|Institution:||University of Oslo|
|Full text PDF:||https://www.duo.uio.no/handle/10852/34511
Background and purpose Little research has been done on the differences in resource consumption within patient groups based on other factors than number of hospital days. Up until now most hospitals have worked with a traditional costing system based on average consumption of resources. The only variable used to explain variation in consumption of resources has been the length of stay. This method does not acknowledge the vast differences in resource consumption within patient groups. The aims of this study are to look at how the average day cost changes throughout the hospital stay. That is, some days are more costly than others. Further, it looks at the differences in costs between patients and the total cost of treating hip fracture patients. Method/objective The objective is to perform a cost analysis with a bottom-up perspective of the real cost of treating hip fracture patients. 26 patients (mean age of 78), 17 women (65%) and 9 men (35%) participated, and data on 204 hospital days were collected during January and February 2012. Resource use at the hospital were identified, quantified, evaluated and analyzed. A probabilistic sensitivity analysis was used to quantify the uncertainty. Results The cost analysis shows great differences between patients regarding resource consumption. With a total cost of stay that differs from 65,718 to 185,812 NOK. The analysis also shows a declining use of resources throughout the hospital stay. The first day has an average cost of 44,917 NOK (36865–51744) while the last (whole) day has an average cost 5062 NOK (4189–5808). To acknowledge that the costs of the last day in hospital are below average could have implications for decision making. Conclusion The study has shown a fall in costs throughout the hospital stay. It has revealed great variation between patients in regard to the consumption of resources as well as length of stay. I have identified that some days are more costly than others, and that the last day has a cost below average. The study also shows a variation in the total cost of stay between patients.