Clinical Pathways as a Tool for Process Costing in Cardiac Surgery

Abstract

Keywords: Clinical pathway ± standard operating procedure ± cost assessment ± cardiac surgery. Schlu Èsselwo Èrter: Standardpfad ± clinical pathway ± standard operating procedure ± Prozeûkostenrechnung ± Herzchirurgie. Summary: Background: By developing a standard clinical pathway, we tried to assess the cost of a coronary bypass procedure at our in institution in order to find possibilities for cost containment and financial decision-making. Methods: A standard clinical pathway was designed for an aortocoronary bypass procedure. Using this pathway, we assessed the procedural costs in a stepwise manner for each individual patient to obtain the average cost for a bypass operation at our institution. Results: Overall costs for a standard coronary bypass operation at our institution were 7411 EUR. Costs for the surgical procedure, intensive care unit, intermediate care unit and 9 days on the ward were 3722 EUR, 1171 EUR, 271 EUR and 558 EUR, respectively. Expenses for personnel amounted to 3194 EUR; for drugs, 78 EUR; for disposables, 2919 EUR; for diagnostics, 274 EUR; and indirect costs, 609 EUR. Conclusions: Standard clinical pathways are a valid means for assessing procedural costs. Making costs transparent is the basis for cost containment, benchmarking and financial decision-making in cardiac surgery. (Eur. Surg. 2003; 35:51±54)

Invited Commentary to:'Clinical Pathways as a Tool for Process Costing in Cardiac Surgery' (Eur. Surg. 2003;35:51-54)

“…Wandschneider and Preiss (1) report in this issue on a novel way to measure and search for these cost‐cutting potentials by using clinical pathways to delineate process costs in cardiac surgery. The attractiveness of this approach lies in the introduction of a modular, interconnected scheme for the calculation of involved costs.…”