Cutting costs: the impact of price lists on the cost development at the emergency department
Cutting costs: the impact of price lists on the cost development at the emergency department
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削减成本：价目表对急诊科成本制定的影响
DOI：
10.1097/mej.0b013e32833651f0
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发表时间：
2010
影响因子：
4.4
通讯作者：
U. M. Schilling
中科院分区：
文献类型：
--
作者：
U. M. Schilling
研究表明，在瑞典急诊科工作的医生并不知道进行调查的费用。这项研究评估了价目表对瑞典一所大学医院急诊室的总体实验室和放射学费用的可能影响。编制了价目表，包括最常见的实验室分析和在教育署进行的放射检查。这些名单通过电子邮件分发给所有内科医生，并不断地在他们的工作台上曝光。骨科对照组没有提供任何名单。计算了2007年6月和7月和2008年6月和7月实验室和放射调查的平均费用。临床和入院程序都没有改变。医生们对这项研究视而不见。统计分析采用学生t检验。2007年共接待了1442名骨科病人和1585名内科病人。2008年，有1467名骨科患者和1637名内科患者需要紧急服务。骨科患者的人均费用为980.27瑞典克朗(98&U20AC；)/999.41瑞典克朗(100&U20AC；，+1.95%)，内科患者为1081.36瑞典克朗(108&U20AC；)/877.3瑞典克朗(88&U20AC；，-18.8%)。骨科和内科患者的实验室费用分别下降了9%和21.4%。骨科患者的放射费用变化为+5.4%，内科患者为-20.59%。教育署派发和推广价目表，作为提高成本意识的工具，大大减低了调查成本。可以观察到放射费用的显著下降。可以得出结论，价格表是削减公共医疗成本的有效工具。
It was shown that physicians working at the Swedish emergency department (ED) are unaware of the costs for investigations performed. This study evaluated the possible impact of price lists on the overall laboratory and radiology costs at the ED of a Swedish university hospital. Price lists including the most common laboratory analyses and radiological investigations at the ED were created. The lists were distributed to all internal medicine physicians by e-mail and exposed above their working stations continually. No lists were provided for the orthopaedic control group. The average costs for laboratory and radiological investigations during the months of June and July 2007 and 2008 were calculated. Neither clinical nor admission procedures were changed. The physicians were blinded towards the study. Statistical analysis was performed using the Student's t-test. A total of 1442 orthopaedic and 1585 medical patients were attended to in 2007. In 2008, 1467 orthopaedic and 1637 medical patients required emergency service. The average costs per patient were 980.27 SKR (98&U20AC;)/999.41 SKR (100&U20AC;, +1.95%) for orthopaedic and 1081.36 SKR (108&U20AC;)/877.3 SKR (88&U20AC;, -18.8%) for medical patients. Laboratory costs decreased by 9% in orthopaedic and 21.4% in medical patients. Radiology costs changed +5.4% in orthopaedic and –20.59% in medical patients. The distribution and promotion of price lists as a tool at the ED to heighten cost awareness resulted in a major decrease in the investigation costs. A significant decrease in radiological costs could be observed. It can be concluded that price lists are an effective tool to cut costs in public healthcare.