1 / 17

Out-patient cost studies in Denmark 2009/2010

Out-patient cost studies in Denmark 2009/2010. Janne Refnov and Line Kirk The National Institute of Health Data and Disease Control. The Danish casemix system. IN-PATIENT ( Based on diagnoses). DkDRG-system. NordDRG 2000 - 2002 DkDRG 2002. OUT-PATIENT ( Based on procedures).

ormand
Download Presentation

Out-patient cost studies in Denmark 2009/2010

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Out-patientcost studiesin Denmark 2009/2010 Janne Refnov and Line Kirk The National Institute of Health Data and Disease Control

  2. The Danish casemix system IN-PATIENT (Basedon diagnoses) DkDRG-system • NordDRG 2000 - 2002 • DkDRG 2002 OUT-PATIENT (Basedon procedures) Bothin- and out-patienttreatment DAGS-system (Danish AmbulatoryGrouping System)

  3. The danishcasemix system Groups: The number of groups in a given year Activity: Out-patient = number of visits, In-patient = number of discharges Costs: Production value based on the DRG rates in a given year dkk.

  4. Goals, preconditions and solution • Goals: • An incresed number of DAGS-rates calculated • A more transparent cost database • Preconditions: • Time – the results had to be incorperated in the cost database 2010 • The studies had to be representative • With a minimum of interference in the daily work on the ward • Solution: • A speciality specific weighting system for all out-patient procedures

  5. Cost Studies I • The desirable/dream scenario: Activity Based Costing analyses of all types of out-patient activity • Estimated ressources: • Two full time employees, eight weeks per speciality. • About 35 specialities. • Significant involvement of the wards • The real scenario: Out-patient cost studies based on the consumption time. • Available ressources: • Two full time employees, two dayes per speciality. • 21 specialities with the possiblity of expansion to all specialities

  6. Cost studies II • Where? • Three wards representing different sizes and locations • Meetings at the hospitals • How long time? • Two hours • Who? • The doctor • The nurse • The secretary

  7. SummAry Problems Limits Solution In the cost database all out-patienttreatment ”cost” the same The DAGS rates areoftenbasedoneducatedguess Time Ressources Easilyupdated A specialityspecificweighting system for all out-patient procedures A weighting system basedon time estimates

  8. The method

  9. Before the meeting • List of registered procedures

  10. During the meeting • Estimated consumption of time for the doctor, the nurse etc. for a standard out-patient examination • and extra time for each procdure carried out

  11. During the meeting • Statement for potential expensive medicaments, utensils or implants X 2.600 kr.

  12. After the meeting - The model Time, doctor standardexamination: 15 min. Rate, doctorstandardexamination: 165 kr. Total time, doctorstandardexaminations: 150 min. Wage, doctor: 2.500 kr. No. of standardexaminations: 10 Rate per min., doctor: 11 kr./min. Total rate,standardexamination: 240 kr. Total time, nursestandardexaminations: 150 min. Total time, doctor: 230 min. Rate, doctor procedure 1: 110 kr. Time, nurse standardexamination: 15 min. Time, doctor procedure 1: 10 min. Rate, nursestandardexamination: 75 kr. Total time, doctorprocedure 1: 80 min. Total time, nurse: 310 min. Total rate, procedure 1: 210 kr. Rate per min., nurse: 5 kr./min. No. of procedure 1: 8 Total time, nurse procedure 1: 160 min. Wage, nurse: 1.500 kr. Time, nurse procedure 1: 20 min. Rate, nurse procedure 1: 100 kr.

  13. From rate to weight • The rate for a standard out-patient examination is set equal to a weight of 100

  14. Co-operation with the clinicians

  15. Results – an example • Two patients A B Standard examination + procedure 1 = weight 100 + 87,5 = weight 187,5 Standard examination = weight 100

  16. Results • Cost weights for 19 specialities used calculating the out-patient (DAGS) rates • The last two specialities did not fit the model assumptions • Extended cost transparency – summable costs per procedure in stead of total costs per examination • Easy to update • Fully developed model

  17. Questions? ?

More Related