Cost accounting in a surgical unit in a teaching hospital - a pilot study

Malalasekera, Ajith; Ariyaratne, M.H.J.; Fernando, Ranil; Perera, D.P.; Deen, K.I.

doi:10.4038/cmj.v48i3.3342

Cited by 9 publications

(6 citation statements)

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“…Several surrogate parameters for healthcare costs were lower after enucleation than after standard resection, such as duration of surgery and length of postoperative hospital stay. These parameters are responsible for a large proportion of hospital costs in surgical departments. For this reason, pancreatic enucleation is of interest not only from the perspective of surgeons and patients but also from the viewpoint of healthcare managers.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of surgical outcome after enucleation versus standard resection for pancreatic neoplasms

Hüttner

Koessler-Ebs

Hackert

et al. 2015

British Journal of Surgery

128

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Background: Pancreatic enucleation is a tissue-sparing approach to pancreatic neoplasms and may result in better postoperative pancreatic function than standard pancreatic resection. The objective of this review was to compare the postoperative outcome after pancreatic enucleation versus standard resection.Methods: MEDLINE, Embase and the Cochrane Library were searched systematically until February 2015 to identify studies comparing the outcome of enucleation versus standard resection for pancreatic neoplasms. After critical appraisal, meta-analysis was performed and the findings were presented as odds ratios or weighted mean differences with corresponding 95 per cent c.i.Results: Twenty-two observational studies (1148 patients) were included. Duration of surgery (P < 0⋅001), blood loss (P < 0⋅001), length of hospital stay (P = 0⋅04), and postoperative endocrine (P < 0⋅001) and exocrine (P = 0⋅01) insufficiency were lower after enucleation than after standard resection. Mortality (P = 0⋅44), overall complications (P = 0⋅74), reoperation rate (P = 0⋅93) and delayed gastric emptying (P = 0⋅15) were not significantly different between the two approaches. The overall rate of postoperative pancreatic fistula (POPF) was higher after enucleation than after standard resection (P < 0⋅001). However, the raised POPF rate did not result in higher mortality or overall morbidity. Sensitivity analysis of high-volume studies (total of more than 20 enucleations and more than 4 per year) showed that, in specialized centres, enucleation can be performed with no increased risk of POPF (P = 0⋅12). Conclusion:Compared with standard resection, pancreatic enucleation can be performed effectively and with comparable safety in high-volume institutions. Enucleation should be considered instead of standard resection for selected pancreatic neoplasms.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of surgical outcome after enucleation versus standard resection for pancreatic neoplasms

Hüttner

Koessler-Ebs

Hackert

et al. 2015

British Journal of Surgery

128

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“…Several audits on costs of patient care have been carried out in Sri Lanka with regards to non-psychiatry specialties (2,3). To the best of our knowledge, no direct data is available on the cost analysis of psychiatric inpatient care received by patients in this country.…”

Section: Discussionmentioning

confidence: 99%

“…Similar findings were reported by a South African cost analysis of an acute mental health unit, with staff salaries being 62.8% of the total expenditure (1). A study done in a surgical unit in Sri Lanka in 2003 found that the highest proportion of the cost (30%) was for basic hospital charges (2). The results of a study done in 2009 in an Intensive Care Unit (ICU) revealed that the cost per bed, per day was Rs.…”

Section: Proportion Of Cost Per Head As a Percentage Of Total Cost Discussionmentioning

confidence: 99%

A financial audit on hospital costs in an inpatient Psychiatry Unit at Teaching Hospital, Anuradhapura, Sri Lanka

Udeshika¹,

Ellepola²

2020

Sri Lanka J. Psyc.

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BackgroundThe Sri Lankan public health care system provides free health care. Psychiatric services in the public sector have expanded over the years to reach the whole country. Currently, the cost of care per patient in a government hospital is not calculated directly. AimsTo assess the total in-ward expenditure, expenditures incurred in different cost heads, average per patient cost and cost per patient day in a psychiatry unit at Teaching Hospital, Anuradhapura, Sri Lanka. MethodsA financial audit was carried out at Teaching Hospital, Anuradhapura. All patients admitted for in-patient psychiatry care from 1st to 30th of September 2019 were included. Data were collected retrospectively from patient documentations and hospital accounting using a data extraction form. ResultsNinety patients, 48 (53.3%) females and 42 (46.7%) males, were included in the study, with 711 in-patient days. The average length of stay was 7.9 days. The mean age was 39.8 years, ranging from 16 to 75 years, and most were married (55.6%). Schizophrenia and depressive disorder were the commonest diagnoses. The total cost per month in the psychiatry unit was LKR 3 321 050.60, with an average of LKR 110 701.70 per day. The average cost per patient per day was LKR 4 670.96. Staff wages accounted for 56.27% of the total expenses, and medications and other consumables accounted for 13.01%. ConclusionsClinicians can carry out cost analysis with data available to them. The results can be used to efficiently allocate resources from the total budget in the given institution, and to implement cost reduction plans to use limited resources effectively.

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“…Ilesanmi OS also mentioned that cost of surgery is 50% of total care expenditure. 4 It also depends on the distance of patients residence from the hospital as when the patients are from the far away they wish to stay for one more day as to avoid any problem to the patients as they might have some problem at house and then it is difficult to them reach back to hospital with in time.…”

Section: Discussionmentioning

confidence: 99%

Study of direct cost of care among ENT surgical inpatients at a tertiary teaching hospital

Agarwal¹,

Bist²,

Kumar³

et al. 2018

Int Surg J

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Background: Cost of care in hospital includes direct cost and indirect cost. Direct cost is a price that patient pays to hospital in form of expenditure. Ever-growing health cost is concern for both health care provider and health care seeker.Methods: Non-sponsored self-paying inpatients of ENT department were included in this prospective study. Structured proforma was used to extract information regarding surgery cost, investigation cost, pharmacy cost, patient care charges and hospital staying charges.Results: Out of 33 patients 49% were admit for >6 days, 39% were admitted up to 3 days, while 12% patients stayed for 4-6 days. Average surgery fees charges were 37% and pharmacy charges and investigation charges were about 25%. 82% patients were operated under general anaesthesia while 18% patients were operated under local anaesthesia.Conclusions: Major surgery under general anaesthesia force patients longer stay in hospital and increases cost of care by increasing pharmacy and investigation bill. So, we should focus on anaesthesia time, anaesthesia type and judicious use of investigations for reducing overall health cost care to make it affordable to all.

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Cost accounting in a surgical unit in a teaching hospital - a pilot study

Cited by 9 publications

References 0 publications

Meta-analysis of surgical outcome after enucleation versus standard resection for pancreatic neoplasms

Meta-analysis of surgical outcome after enucleation versus standard resection for pancreatic neoplasms

A financial audit on hospital costs in an inpatient Psychiatry Unit at Teaching Hospital, Anuradhapura, Sri Lanka

Study of direct cost of care among ENT surgical inpatients at a tertiary teaching hospital

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