Analysis of costs and benefits of a re-accreditation of a Swiss acute care hospital

Abstract

Background: Accreditation of hospitals and other institutions is a widely used instrument for the quality assurance in health care. However, relevant literature regarding the economic evaluation of hospital accreditation is still missing. To date no formal Cost-Benefit Analysis (CBA) or Cost-Utility Analysis (CUA) has been carried out. Methods: This study uses an existing framework specifically developed for the economic evaluation of hospital accreditation. Based on this framework, we identify and quantify the costs and selected benefits of the re-accreditation of a Swiss acute care hospital. Costs are identified and quantified by conducting key informant and expert interviews. Benefits are identified by hospital experts and rated using a newly developed validation tool. Results: Costs of the re-accreditation amount to about CHF 870'000 (internal and external costs). Benefits in quality management (QM) and in the critical incident reporting system (CIRS) are quantified and rated by the hospital experts in the following order: (1) development or promotion of a quality or safety culture, (2) implementation of a hospital-wide complaint management, (3) fulfillment of the hospital vision, (4) improved image upon stakeholders (patients, suppliers etc.), (5) improved image in policy, (6) quality dashboard, (7) preparation of centralized quality documents, and (8) avoidance of liability cases. Conclusion: This study provides detailed information about costs and selected benefits associated with the re-accreditation of a Swiss acute care hospital. As opposed to the costs, benefits could not be monetized but were quantified using an expert rating to illustrate the impacts of the re-accreditation. Overall, our study confirms the difficulties in the economic evaluation of hospital accreditation, but it makes a step towards a formal CUA.