PMID- 9534295
OWN - NLM
STAT- MEDLINE
DCOM- 19980521
LR  - 20061115
IS  - 0393-1978 (Print)
IS  - 0393-1978 (Linking)
VI  - 43
IP  - 1
DP  - 1998 Jan
TI  - [Treatment aspects of unstable angina. Costs and payments for DRG].
PG  - 67-75
AB  - Patients with unstable angina fall into a wide prognostic and therapeutic 
      spectrum but, in general, have great access to specialty care and invasive 
      procedures. In the modern era, in which admissions for unstable angina outnumber 
      those for myocardial infarction, and growing economic pressures are placed on 
      health care systems, cardiologists must re-examine clinical strategies for 
      treating unstable angina in the light of health-cost accounting. The aims of the 
      present study were to examine the current management of patients admitted to our 
      cardiology department and to calculate the medical costs. A patient schedule was 
      drawn up to prospectively register the number and type of cardiac processes 
      carried out during hospitalization for all unstable angina patients in the period 
      between March 1st and May 30th, 1995. Time (minutes) actually spent by both 
      physicians and nurses for each cardiac process were carefully recorded in order 
      to calculate the activity budget. The effective economic budget was built for 
      each cardiac process taking into account salaries, consumable supplies, equipment 
      service contracts, depreciation and indirect medical and non medical costs for 
      CCU and ward. Based to the Diagnosis Related Groups (DRG) system, 53 out of 318 
      patients (16%) were admitted with documented or suspected unstable angina and 
      allocated to discharge into four DRGs: DRG 140-medically treated unstable angina: 
      18 patients; DRG 124-unstable angina with angiography: 16 patients; DRG 
      122-unstable angina evolving in myocardial infarction: 6 patients; DRG 
      112-unstable angina with angioplasty: 13 patients. The mean cost for hospitalized 
      patient with unstable angina was 5,574,958 Italian Liras (DRG 140 = 2,687,719; 
      DRG 124 = 2,800,347; DRG 122 = 6,086,563; DRG 112 = 12,751,454). The difference 
      in costs was essentially related to the procedures involved in medical care, DRGs 
      with expensive cardiac processes having higher costs. Furthermore, these data 
      show a deep discrepancy between "real" costs and current DRG reimbursement. In 
      conclusion, data show the standard management of unstable angina at our center; 
      calculating the true costs of unstable angina is the first step towards 
      maximizing resources and optimizing benefits.
FAU - Brunelli, C
AU  - Brunelli C
AD  - Dipartimento di Medicina Interna, Universita degli Studi, Genova.
FAU - Spallarossa, P
AU  - Spallarossa P
FAU - Pasdera, A
AU  - Pasdera A
FAU - Bezante, G P
AU  - Bezante GP
FAU - Zorzet, F
AU  - Zorzet F
FAU - Rossettin, P
AU  - Rossettin P
LA  - ita
PT  - English Abstract
PT  - Journal Article
TT  - Aspetti gestionali dell'angina instabile. Costi reali e tariffe per DRG.
PL  - Italy
TA  - Cardiologia
JT  - Cardiologia (Rome, Italy)
JID - 8506637
SB  - IM
MH  - Angina, Unstable/diagnosis/economics/*therapy
MH  - *Diagnosis-Related Groups
MH  - Humans
MH  - Italy
EDAT- 1998/04/16 00:00
MHDA- 1998/04/16 00:01
CRDT- 1998/04/16 00:00
PHST- 1998/04/16 00:00 [pubmed]
PHST- 1998/04/16 00:01 [medline]
PHST- 1998/04/16 00:00 [entrez]
PST - ppublish
SO  - Cardiologia. 1998 Jan;43(1):67-75.