scholarly journals PATIENT CLASSIFICATION SYSTEMS AND HOSPITAL COSTS OF CARE FOR KNEE REPLACEMENT IN 10 EUROPEAN COUNTRIES

2012 ◽  
Vol 21 ◽  
pp. 116-128 ◽  
Author(s):  
Francesc Cots ◽  
Pietro Chiarello ◽  
Xavier Salvador ◽  
Xavier Castells ◽  
Keyword(s):  
Knee Replacement ◽  
Hospital Costs ◽  
Classification Systems ◽  
European Countries ◽  
Patient Classification ◽  
Costs Of Care

scholarly journals PATIENT CLASSIFICATION AND HOSPITAL COSTS OF CARE FOR ACUTE MYOCARDIAL INFARCTION IN NINE EUROPEAN COUNTRIES

2012 ◽  
Vol 21 ◽  
pp. 19-29 ◽  
Author(s):  
Unto Häkkinen ◽  
Pietro Chiarello ◽  
Francesc Cots ◽  
Mikko Peltola ◽  
Hanna Rättö ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Costs ◽  
European Countries ◽  
Patient Classification ◽  
Costs Of Care

scholarly journals The hospital costs of care for stroke in nine European countries

2008 ◽  
Vol 17 (S1) ◽  
pp. S21-S31 ◽  
Author(s):  
David Epstein ◽  
Anne Mason ◽  
Andrea Manca
Keyword(s):  
Hospital Costs ◽  
European Countries ◽  
Costs Of Care

scholarly journals The Criterion Validity, Reliability, and Feasibility of an Instrument for Assessing the Nursing Intensity in Perioperative Settings

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Satu Rauta ◽  
Sanna Salanterä ◽  
Tero Vahlberg ◽  
Kristiina Junttila
Keyword(s):  
Predictive Validity ◽  
Interrater Reliability ◽  
Criterion Validity ◽  
Classification Systems ◽  
Patient Classification ◽  
University Hospitals ◽  
Care Needs ◽  
Perioperative Nurses ◽  
Staff Allocation

Patient classification systems generate information for staff allocation based on a patient’s care needs. This study aims to test further the instrument for assessing nursing intensity (NI) in perioperative settings. Nine operating departments from five university hospitals were involved. The perioperative nurses gathered data from patients (N=876) representing different fields of surgery. Reliability was tested by parallel classifications (n=144). Also, the users’ (n=40) opinions were surveyed. The results support the predictive validity and interrater reliability of the instrument. The nurses considered the instrument feasible to use. The patients’ low ASA class did not automatically signify low NI; however, high ASA class was more frequently associated with high intraoperative NI. Intraoperative NI indicated the length of the postanaesthesia care and the type of the follow-up unit. Parallel classifications ensured the homogenous use of the instrument. The use of the instrument is recommended.

Hospital Costs and Severity of Illness in Three Types of Elective Surgery

1997 ◽  
Vol 86 (1) ◽  
pp. 92-100 ◽  
Author(s):  
Alex Macario ◽  
Terry S. Vitez ◽  
Brian Dunn ◽  
Tom McDonald ◽  
Byron Brown
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Length Of Stay ◽  
Operating Room ◽  
Knee Replacement ◽  
Charlson Comorbidity Index ◽  
Elective Surgery ◽  
Hospital Costs ◽  
Severity Of Illness ◽  
Total Hospital ◽  
Comorbidity Index

Background If patients who are more severely ill have greater hospital costs for surgery, then health-care reimbursements need to be adjusted appropriately so that providers caring for more seriously ill patients are not penalized for incurring higher costs. The authors' goal for this study was to determine if severity of illness, as measured by either the American Society of Anesthesiologists Physical Status (ASA PS) or the comorbidity index developed by Charlson, can predict anesthesia costs, operating room costs, total hospital costs, or length of stay for elective surgery. Methods The authors randomly selected 224 inpatients (60% sampling fraction) having either colectomy (n = 30), total knee replacement (n = 100), or laparoscopic cholecystectomy (n = 94) from September 1993 to September 1994. For each surgical procedure, backward-elimination multiple regression was used to build models to predict (1) total hospital costs, (2) operating room costs, (3) anesthesia costs, and (4) length of stay. Explanatory candidate variables included patient age (years), sex, ASA PS, Charlson comorbidity index (which weighs the number and seriousness of coexisting diseases), and type of insurance (Medicare/Medicaid, managed care, or indemnity). These analyses were repeated for the pooled data of all 224 patients. Costs (not patient charges) were obtained from the hospital cost accounting software. Results Mean total hospital costs were $3,778 (95% confidence interval +/- 299) for laparoscopic cholecystectomy, $13,614 (95% CI +/- 3,019) for colectomy, and $18,788 (95% CI +/- 573) for knee replacement. The correlation (r) between ASA PS and Charlson comorbidity scores equaled 0.34 (P < .001). No consistent relation was found between hospital costs and either of the two severity-of-illness indices. The Charlson comorbidity index (but not the ASA PS) predicted hospital costs only for knee replacement (P = .003). The ASA PS, but not the Charlson index, predicted operating room and anesthesia costs only for colectomy (P < .03). Conclusions Severity of illness, as categorized by ASA PS categories 1-3 or by the Charlson comorbidity index, was not a consistent predictor of hospital costs and lengths of stay for three types of elective surgery. Hospital resources for these lower-risk elective procedures may be expended primarily to manage the consequences of the surgical disease, rather than to manage the patient's coexisting diseases.

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