TY  - JOUR
PY  - 2015//
TI  - Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model
JO  - Swiss medical weekly
A1  - Mehra, Tarun
A1  - Koljonen, Virve
A1  - Seifert, Burkhardt
A1  - Volbracht, Jörk
A1  - Giovanoli, Pietro
A1  - Plock, Jan
A1  - Moos, Rudolf Maria
SP  - w14217
EP  - w14217
VL  - 145
IS  - 
N2  - 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>
LA  - en
SN  - 1424-7860
UR  - http://dx.doi.org/10.4414/smw.2015.14217
ID  - ref1
ER  -