Vergleich der Kosten- und Erlössituation invasiver und konservativer kardiologischer Behandlungsfälle: Modell einer Deckungsbeitragsrechnung

Plehn, Gunnar; Oernek, Ahmet; Vormbrock, J.; Maagh, Petra; Butz, Thomas; Meißner, Axel

doi:10.1055/s-0041-110672

Cited by 2 publications

(1 citation statement)

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“…In response, healthcare providers developed marketing strategies to increase patient number and throughput [2]. Furthermore, the importance of cost control instruments has increasingly been recognized [7]. …”

Section: Introductionmentioning

confidence: 99%

Is it time to rebalance the case mix? A portfolio analysis of direct catheterization laboratory costs over a 5-year period

et al. 2016

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BackgroundCardiac catheterization laboratories (CLL) have continued to function as profit centers for hospitals. Due to a high percentage of material and labor costs, they are natural targets for process improvement. Our study applied a contribution margin (CBM) concept to evaluate costs and cost dynamics over a 5-year period.MethodsWe retrospectively analyzed all procedures performed at a tertiary heart center between 2007 and 2011. Total variable costs, including labor time, material, and maintenance-expenses, were allocated at a global as well as a procedural level. CBM and CBM ratios were calculated by integration of individual DRG revenues.ResultsAnnual case volume increased from 1288 to 1545. In parallel, overall profitability improved as indicated by a 2% increase in CBM ratio and a higher CBM generated per hour of CLL working time (4325 vs. 5892 €, p < 0.001). Coronary angiography generated higher average CBMs per hour than coronary or electrophysiological interventions (5831 vs. 3458 vs. 1495 €; p < 0.001). The latter are characterized by relatively high per case material expenditures. On a procedural level, DRG-specific trends as a steady improvement of examination time or an increase in material costs were detectable.ConclusionsThe CBM concept allows a comprehensive analysis of CLL costs and cost dynamics. From a health service providers view, its range of application includes global profitability analysis, portfolio evaluation, and a detailed cost analysis of specific service lines. From a healthcare payers perspective, it may help to monitor hospital activities and to provide a solid data basis in cases where inappropriate developments are suspected. The calculation principle is simple which may increase user acceptance and thus the motivation of team members.Electronic supplementary materialThe online version of this article (doi:10.1186/s40001-016-0238-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Is it time to rebalance the case mix? A portfolio analysis of direct catheterization laboratory costs over a 5-year period

et al. 2016

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Effect of patient’s age on the profitability of inpatient cardiac catheterization: a contribution margin analysis of frequently performed procedures over a 5-year period

Plehn

Butz

Maagh

et al. 2017

BMC Health Serv Res

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BackgroundDue to a continuing age shift in the German society hospital providers are concerned about the additional costs associated with the treatment of elderly patients. It is not clear if cardiac catheterization in aged patients leads to higher resource utilization and if DRG-revenues do compensate for this factor.MethodsProcedure-related and administrative data of all patients who underwent cardiac catheterization at a tertiary heart center between 2007 and 2011 were collected and analyzed. Then a profitability analysis was performed by comparing the case related variable costs with the Diagnosis-related group (DRG) per case revenues. A particular emphasis was placed on a comparative analysis of identical clusters of procedures.ResultsThe most frequently performed catheterization procedure (n = 1800) was associated with significantly higher material expenditure in very old patients (178 ± 48 €) than in old (171 ± 28; p = 0.001) and young patients (172 ± 39; p = 0.046). Furthermore, radiation time and the length of hospital stay were increased in very old patients (3.5 ± 3.8 min and 6.2 ± 4.8 days) compared to old (2.7 ± 2.8 min and 4.6 ± 3.8 days; p < 0.001) and young patients (2.5 ± 2.5 min and 4.5 ± 3.9 days; p < 0.001). Due to higher DRG revenues very old patients achieved higher absolute contribution margins (2065 ± 1033 €) than old (1804 ± 1902 €; p < 0.001) and young patients (1771 ± 902 €; p < 0.001). However, the contribution margins per day were significantly smaller (440 ± 226 €) than those in old (488 ± 234 €; p = 0.001) and young patients (484 ± 206 €; p = 0.001).ConclusionsCatheterization of very old patients is related to lower contribution margins per day despite higher material and time expenditures. Since efforts to reduce the length of hospital stay of these patients are limited, this may result in a competitive disadvantage of hospitals which are more affected by the demographic change.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-1999-4) contains supplementary material, which is available to authorized users.

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Vergleich der Kosten- und Erlössituation invasiver und konservativer kardiologischer Behandlungsfälle: Modell einer Deckungsbeitragsrechnung

Cited by 2 publications

References 10 publications

Is it time to rebalance the case mix? A portfolio analysis of direct catheterization laboratory costs over a 5-year period

Is it time to rebalance the case mix? A portfolio analysis of direct catheterization laboratory costs over a 5-year period

Effect of patient’s age on the profitability of inpatient cardiac catheterization: a contribution margin analysis of frequently performed procedures over a 5-year period

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