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Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study

BACKGROUND: In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of t...

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Autores principales: Napierala, Christoph, Boes, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329950/
https://www.ncbi.nlm.nih.gov/pubmed/28241757
http://dx.doi.org/10.1186/s12913-017-2055-0
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author Napierala, Christoph
Boes, Stefan
author_facet Napierala, Christoph
Boes, Stefan
author_sort Napierala, Christoph
collection PubMed
description BACKGROUND: In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of this study is to describe the relationship between timing of radiological interventions, in particular scan and treatment day, and the length of stay (LOS) compliance in a hospital. METHODS: This is a cross-sectional observational study based on administrative records of all DRG cases in a Swiss university hospital in 2013, enriched by data from the radiology information system and accounting details. The data are analysed using descriptive statistics and regression methods. RESULTS: Radiology and related treatment on a weekend is associated with a higher LOS compliance of approximately 22.12% (p<0.01) compared to scans and treatments on weekdays, controlling for gender, age and insurance of the patient, as well as detailed medical and radiology-related factors. The higher LOS compliance is driven by emergency cases, which supports the hypothesis that for those cases on weekends more efficient scan and treatment processes are in place. CONCLUSION: The study provides evidence on how days of radiological intervention are related to LOS compliance in a Swiss hospital under DRG and attempts to explain how this is linked to standardised operating procedures. Our results have implications regarding potential cost savings in hospital care through alignment of care processes, infrastructure planning and guidance of patient flows. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-017-2055-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-53299502017-03-03 Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study Napierala, Christoph Boes, Stefan BMC Health Serv Res Research Article BACKGROUND: In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of this study is to describe the relationship between timing of radiological interventions, in particular scan and treatment day, and the length of stay (LOS) compliance in a hospital. METHODS: This is a cross-sectional observational study based on administrative records of all DRG cases in a Swiss university hospital in 2013, enriched by data from the radiology information system and accounting details. The data are analysed using descriptive statistics and regression methods. RESULTS: Radiology and related treatment on a weekend is associated with a higher LOS compliance of approximately 22.12% (p<0.01) compared to scans and treatments on weekdays, controlling for gender, age and insurance of the patient, as well as detailed medical and radiology-related factors. The higher LOS compliance is driven by emergency cases, which supports the hypothesis that for those cases on weekends more efficient scan and treatment processes are in place. CONCLUSION: The study provides evidence on how days of radiological intervention are related to LOS compliance in a Swiss hospital under DRG and attempts to explain how this is linked to standardised operating procedures. Our results have implications regarding potential cost savings in hospital care through alignment of care processes, infrastructure planning and guidance of patient flows. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-017-2055-0) contains supplementary material, which is available to authorized users. BioMed Central 2017-02-28 /pmc/articles/PMC5329950/ /pubmed/28241757 http://dx.doi.org/10.1186/s12913-017-2055-0 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Napierala, Christoph
Boes, Stefan
Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study
title Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study
title_full Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study
title_fullStr Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study
title_full_unstemmed Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study
title_short Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study
title_sort is the timing of radiological intervention and treatment day associated with economic outcomes in drg-financed health care systems: a case study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329950/
https://www.ncbi.nlm.nih.gov/pubmed/28241757
http://dx.doi.org/10.1186/s12913-017-2055-0
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