Los GRDs Psiquiátricos: Una investigación pendiente

Abstract

Con el fin de mejorar la gestión y la eficiencia de los Servicios, surgieron hace años los sistemas de RESUMEN -Los GRDs (grupos relacionados en el diagnóstico) se han mostrado muy úti-les para lograr aproximaciones a los costes generados por la actividad médica con referencia a los diferentes diagnósticos, sin embargo en Psiquiatría las categorías diagnósticas actualmente utilizadas son tan limitadas que requieren una mayor profundización y discernimiento.Los autores estudian los 10.974 ingresos psiquiátricos producidos entre los años 1975 al 2000 en el Departamento de Psiquiatría del Hospital Clínico Universitario de Zaragoza (España), mostrando las diferencias en cuanto a las estancias medias según diferentes factores como el sexo de pertenencia, la edad, el estado civil, la situación laboral, la clase social, el lugar de residencia, la dependencia asistencial del paciente, el tipo de ingreso, la tasa de reingresos y por supuesto el diagnóstico psiquiátrico.

Adaptation of activity-based-costing (ABC) to calculate unit costs in Mental Health Care in Spain

“…Moreover, this methodology makes possible cost calculation according to different temporal horizons; that is, we can calculate unit cost in a specific service per day, per month, per year or per stay; for example, in Table II we have calculated the cost for a stay of 17 days long, but if our patient had stayed 25 days the cost would be different and its calculation is very easy; this possibility is impossible with traditional systems as DRG in this case only gives one figure for all patients included in 430 group. This problem with DRG methodology has been already stated for many health's areas and Psychiatry is not an exception 27 .…”

“…As one example of these outcomes, we display results for a specific service; we have chosen the Psychiatric Ward in Hospital because we can show differences in costs between our results and D.R.G. methodology that it's commonly accepted and used 17,27,28 . This resource is codified with R2, code of European Service Mapping Schedule (ESMS); in Figure 1, we show the organizational and management structure of Mental Health's public services.…”

“…Faced with the necessity of an improved methodology to calculate unit costs in mental health care, we have implemented ABC system obtaining results very different from the ones reached by traditional methods; in this way we have obtained cost per care's process since this alternative was already suggested as the best option but it had never been carried out 27,28 .…”