@article{ref1,
title="Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model",
journal="Swiss medical weekly",
year="2015",
author="Mehra, Tarun and Koljonen, Virve and Seifert, Burkhardt and Volbracht, Jörk and Giovanoli, Pietro and Plock, Jan and Moos, Rudolf Maria",
volume="145",
number="",
pages="w14217-w14217",
abstract="PRINCIPLES: Reimbursement systems have difficulties depicting the actual cost of burn treatment, leaving care providers with a significant financial burden. Our aim was to establish a simple and accurate reimbursement model compatible with prospective payment systems. <br><br>METHODS: A total of 370 966 electronic medical records of patients discharged in 2012 to 2013 from Swiss university hospitals were reviewed. A total of 828 cases of burns including 109 cases of severe burns were retained. Costs, revenues and earnings for severe and nonsevere burns were analysed and a linear regression model predicting total inpatient treatment costs was established. <br><br>RESULTS: The median total costs per case for severe burns was tenfold higher than for nonsevere burns (179 949 CHF [167 353 EUR] vs 11 312 CHF [10 520 EUR], interquartile ranges 96 782-328 618 CHF vs 4 874-27 783 CHF, p <0.001). The median of earnings per case for nonsevere burns was 588 CHF (547 EUR) (interquartile range -6 720 - 5 354 CHF) whereas severe burns incurred a large financial loss to care providers, with median earnings of -33 178 CHF (30 856 EUR) (interquartile range -95 533 - 23 662 CHF). Differences were highly significant (p <0.001). Our linear regression model predicting total costs per case with length of stay (LOS) as independent variable had an adjusted R2 of 0.67 (p <0.001 for LOS). <br><br>CONCLUSIONS: Severe burns are systematically underfunded within the Swiss reimbursement system. Flat-rate DRG-based refunds poorly reflect the actual treatment costs. In conclusion, we suggest a reimbursement model based on a per diem rate for treatment of severe burns.<p /> <p>Language: en</p>",
language="en",
issn="1424-7860",
doi="10.4414/smw.2015.14217",
url="http://dx.doi.org/10.4414/smw.2015.14217"
}