PMID- 12389074
OWN - NLM
STAT- MEDLINE
DCOM- 20030514
LR  - 20061115
IS  - 0934-0874 (Print)
IS  - 0934-0874 (Linking)
VI  - 15
IP  - 9-10
DP  - 2002 Oct
TI  - A comparison of actual cost, DRG-based cost, and hospital reimbursement for liver 
      transplant patients.
PG  - 439-45
AB  - The financing of health care services in Norway has been changed from a system of 
      global budgeting to a system partly based on Diagnosis-Related Groups (DRG). The 
      government has decided to derive a part of the hospital revenue from DRG-based, 
      per-patient financing. The aim of this study is to determine whether the present 
      remuneration system covers the actual hospital expenses of liver transplant 
      patients, and whether the present method of calculating DRG-costs is adequate for 
      our institution. Our group developed a prospective method of determining the 
      actual cost per patient. We closely observed and collected the data of eight 
      liver transplant patients during their hospital stay. We divided each of the 
      patients' resource requirements into four categories; heavy intensive care, light 
      intensive care, intermediate care, and ordinary care. In addition, we recorded 
      the number of staff involved, the duration of surgery, the major procedures, and 
      the medical- and material costs. The actual cost of each patient was calculated, 
      based on these data. The actual cost was compared with the corresponding hospital 
      remuneration for each patient. Median cost for liver transplantation was NOK 
      536.785 (range: NOK 295.113-NOK 844.345) (1$=7,5 NOK), while the corresponding 
      hospital refund was NOK 457.785 (range: NOK 436.465-NOK 483.040). The difference 
      is not statistically significant ( P=0.2). The average 100% DRG-based cost of a 
      liver transplantation was NOK 730.321, which is significantly higher than the 
      actual cost ( P=0.02). The hospital's reimbursement for liver transplantation did 
      not differ significantly from the actual registered cost. The computed cost was 
      significantly lower than the DRG-based cost.
FAU - Skeie, Bjorn
AU  - Skeie B
AD  - Department of Anaesthesiology, University Hospital, Sognsvannsv. 20, 0027 Oslo, 
      Norway. bjorn.skeie@vas.no
FAU - Mishra, Vinod
AU  - Mishra V
FAU - Vaaler, Stein
AU  - Vaaler S
FAU - Amlie, Einar
AU  - Amlie E
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20020924
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
SB  - IM
MH  - Costs and Cost Analysis
MH  - Diagnosis-Related Groups/*economics
MH  - *Economics, Hospital
MH  - Humans
MH  - Length of Stay/economics
MH  - Liver Transplantation/*economics
MH  - Norway
MH  - Nursing Staff, Hospital/economics
MH  - Reimbursement Mechanisms
EDAT- 2002/10/22 04:00
MHDA- 2003/05/15 05:00
CRDT- 2002/10/22 04:00
PHST- 2001/02/28 00:00 [received]
PHST- 2002/02/22 00:00 [revised]
PHST- 2002/04/30 00:00 [accepted]
PHST- 2002/10/22 04:00 [pubmed]
PHST- 2003/05/15 05:00 [medline]
PHST- 2002/10/22 04:00 [entrez]
AID - 10.1007/s00147-002-0430-0 [doi]
PST - ppublish
SO  - Transpl Int. 2002 Oct;15(9-10):439-45. doi: 10.1007/s00147-002-0430-0. Epub 2002 
      Sep 24.