Deutsches Ärzteblatt International | Dtsch Arztebl Int 2017; 114: 705-11 16. Bee PE, Richards DA, Loftus SJ, et al.: Mapping nursing activity in acute inpatient mental healthcare settings. J Ment Health 2006; 15: 217-26. KEY MESSAGES• Inpatient care accounted for 53% of physicians' work-time. A total of 34% was spent on outpatient care and 13% on other activities, e.g., waiting, moving from place to place, and breaks.• Overall, 46% of working time on the wards in the participating departments was spent in direct contact with patients (e.g., rounds, operations, obtaining blood samples).• One third of inpatient work-time was occupied by indirect care, i.e., work in connection with particular patients but not in their presence (e.g., treatment documentation, discharge letters).• The departments of ophthalmology, dermatology, gynecology, pediatrics, oral and maxillofacial surgery, orthopedics and trauma surgery, and psychiatry and psychotherapy of the Medical Center-University of Freiburg took part in the study.• The knowledge that they were taking part in a study may have altered the physicians' behavior.

BackgroundTechnical efficiency of hospital services is debated since performance has been heterogeneous. Staff time represents the main resource in patient care and its inappropriate allocation has been identified as a key factor of inefficiency. The aim of this study was to analyse the utilisation of physicians’ work time stratified by staff groups, tasks and places of work. A further aim was to use these data to estimate resource use per unit of output.MethodsA self-reporting work-sampling study was carried during 14-days at a University Eye Hospital. Staff costs of physicians per unit of output were calculated at the wards, the operating rooms and the outpatient unit.ResultsForty per cent of total work time was spent in contact with the patient. Thirty per cent was spent with documentation tasks. Time spent with documentation tasks declined monotonically with increasing seniority of staff. Unit costs were 56 € per patient day at the wards, 77 € and 20 € per intervention at the operating rooms for inpatients and outpatients, respectively, and 33 € per contact at the outpatient unit. Substantial differences in resources directly dedicated to the patient were found between these locations.ConclusionThe presented data provide unprecedented units costs in inpatient Ophthalmology. Future research should focus on analysing factors that influence differences in time allocation, such as types of patients, organisation of care processes and composition of staff.

IntroductionStaff time is a relevant resource in the delivery of health care interventions. Its measurement is a prerequisite for unit costing but usually complex. The aim of this study was to analyse the distribution of surgeons' work time among types and places of activities. A second aim was to use these data to calculate costs per unit of output.MethodsA self-reporting work sampling study was carried out at a department of Urology. All of twelve surgeons involved in clinical care participated in a two-week analysis of their work time.ResultsA total of 2,485 data-points were collected, representing about 1,242 hours of work time. Surgeons spent the greater part of their work time in direct patient care, but substantial shares were required for documentation and organisation. Assistants were mainly required at the wards and consultants at the operating theatre and the outpatient unit. Staff costs of surgeons were 32 € and 29 € per patient day at the wards, respectively, 1.30 € per minute at the operating theatre and 32 € per visit at the outpatient unit.ConclusionResults provided a basis for costing of health care interventions at the study site. However, future research should focus on the establishment of standardised terminology in order to increase transferability of results.