Article type
Year
Abstract
Background: Evidence-based medicine (EbM) and Health Technology Assessments (HTA) aim to improve health care and allocation of resources, so besides clinical aspects, cost calculations are becoming more important, with selection of data being crucial for an appropriate calculation.
Objectives: Comparison of the costs of day surgical and inpatient varicose vein surgery as an example to show the results of using different data sources.
Methods: For the first approach, we used meta-data from the Austrian “Dokumentations- und Informationssystem für Analysen im Gesundheitswesen“. We considered generated lump sums from hospital reimbursement, total costs that occurred in the departments and number of patients in an equation.
For the second approach, we used data from individual hospitals to calculate the costs for the surgery itself and nursing.
The third approach contained the adaption of international cost data, by an adjustment for inflation and prices for Austria.
Results: The calculated costs of varicose vein surgery differed between EUR 859 and EUR 4664 for a day case and EUR 1720 to 2330 for an inpatient treatment – depending on the used approach.
The main strength of the first approach is that it can be done relatively quickly. However, the validity of the calculated costs is low. Thus, a difference between real and calculated costs is likely.
The use of hospital data takes more time, though, the quality of the data is much better. A weakness of this approach is that individual costs are not available for a specific intervention. Furthermore, these costs are hospital specific and generalising for other hospitals is difficult.
The fast acquisition of the international reference costs is a main strength, though, the costs are from a different healthcare system and therefore, the transferability of the costs is limited.
Conclusions: The results have shown that an examination of administrative data is indispensable for proper cost evidence. Calculations of costs for EbM and HTA that are adjusted to national circumstances are required. However, many issues of an efficient healthcare system and appropriate allocation of resources are unsolved.
Objectives: Comparison of the costs of day surgical and inpatient varicose vein surgery as an example to show the results of using different data sources.
Methods: For the first approach, we used meta-data from the Austrian “Dokumentations- und Informationssystem für Analysen im Gesundheitswesen“. We considered generated lump sums from hospital reimbursement, total costs that occurred in the departments and number of patients in an equation.
For the second approach, we used data from individual hospitals to calculate the costs for the surgery itself and nursing.
The third approach contained the adaption of international cost data, by an adjustment for inflation and prices for Austria.
Results: The calculated costs of varicose vein surgery differed between EUR 859 and EUR 4664 for a day case and EUR 1720 to 2330 for an inpatient treatment – depending on the used approach.
The main strength of the first approach is that it can be done relatively quickly. However, the validity of the calculated costs is low. Thus, a difference between real and calculated costs is likely.
The use of hospital data takes more time, though, the quality of the data is much better. A weakness of this approach is that individual costs are not available for a specific intervention. Furthermore, these costs are hospital specific and generalising for other hospitals is difficult.
The fast acquisition of the international reference costs is a main strength, though, the costs are from a different healthcare system and therefore, the transferability of the costs is limited.
Conclusions: The results have shown that an examination of administrative data is indispensable for proper cost evidence. Calculations of costs for EbM and HTA that are adjusted to national circumstances are required. However, many issues of an efficient healthcare system and appropriate allocation of resources are unsolved.