Costing Hospital Surgery Services: The Method Matters
Costing Hospital Surgery Services: The Method Matters
复制标题
DOI：
10.1371/journal.pone.0097290
复制
发表时间：
2014-05-09
期刊：
影响因子：
3.7
通讯作者：
Naro, Gerald
中科院分区：
文献类型：
--
作者：
Mercier, Gregoire;Naro, Gerald
背景：准确的医院成本是政策制定者、医院管理者和临床医生提高效率和透明度所必需的。然而，分配直接成本的方法不同，人们对它们的一致性了解甚少。本研究的目的是评估自下而上和自上而下的单位成本之间的协议，一个大样本的外科手术在法国的第三centre.Methods：2010年1月至10月进行了2130连续程序进行了分析。自上而下的成本是根据预先确定的权重计算的，而自下而上的成本则是通过基于活动的成本计算模式计算的。使用相关系数和Bland和Altman方法评估一致性。结果：相关系数为0.73（95%CI：0.72; 0.76）。方法之间的总体一致性较差。在多变量分析中，成本差异与年龄（Beta = -2.4; p = 0.02）、阿萨评分（Beta = 76.3; p = 0.05）、
Background: Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre.Methods: Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC) model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions.Results: The correlation coefficient amounted to 0.73 (95% CI: 0.72; 0.76). The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = -2.4; p = 0.02), ASA score (Beta = 76.3; p