The Expenditures for Academic Inpatient Care of Inflammatory Bowel Disease Patients Are Almost Double Compared with Average Academic Gastroenterology and Hepatology Cases and Not Fully Recovered by Diagnosis-Related Group (DRG) Proceeds
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{"title"=>"The Expenditures for Academic Inpatient Care of Inflammatory Bowel Disease Patients Are Almost Double Compared with Average Academic Gastroenterology and Hepatology Cases and Not Fully Recovered by Diagnosis-Related Group (DRG) Proceeds", "type"=>"journal", "authors"=>[{"first_name"=>"Daniel C.", "last_name"=>"Baumgart", "scopus_author_id"=>"7006272602"}, {"first_name"=>"Marie", "last_name"=>"Le Claire", "scopus_author_id"=>"55340483300"}], "year"=>2016, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84958230818", "sgr"=>"84958230818", "doi"=>"10.1371/journal.pone.0147364", "pui"=>"608240279", "pmid"=>"26784027", "issn"=>"19326203"}, "id"=>"24f87d4b-abf5-3fe4-8e7f-42bb3cf377c7", "abstract"=>"BACKGROUND Crohn's disease (CD) and ulcerative colitis (UC) challenge economies worldwide. Detailed health economic data of DRG based academic inpatient care for inflammatory bowel disease (IBD) patients in Europe is unavailable. METHODS IBD was identified through ICD-10 K50 and K51 code groups. We took an actual costing approach, compared expenditures to G-DRG and non-DRG proceeds and performed detailed cost center and type accounting to identify coverage determinants. RESULTS Of all 3093 hospitalized cases at our department, 164 were CD and 157 UC inpatients in 2012. On average, they were 44.1 (CD 44.9 UC 43.3 all 58) years old, stayed 10.1 (CD 11.8 UC 8.4 vs. all 8) days, carried 5.8 (CD 6.4 UC 5.2 vs. all 6.8) secondary diagnoses, received 7.4 (CD 7.7 UC 7 vs. all 6.2) procedures, had a higher cost weight (CD 2.8 UC 2.4 vs. all 1.6) and required more intense nursing. Their care was more costly (means: total cost IBD 8477€ CD 9051€ UC 7903€ vs. all 5078€). However, expenditures were not fully recovered by DRG proceeds (means: IBD 7413€, CD 8441€, UC 6384€ vs all 4758€). We discovered substantial disease specific mismatches in cost centers and types and identified the medical ward personnel and materials budgets to be most imbalanced. Non-DRG proceeds were almost double (IBD 16.1% vs. all 8.2%), but did not balance deficits at total coverage analysis, that found medications (antimicrobials, biologics and blood products), medical materials (mostly endoscopy items) to contribute most to the deficit. CONCLUSIONS DRGs challenge sophisticated IBD care.", "link"=>"http://www.mendeley.com/research/expenditures-academic-inpatient-care-inflammatory-bowel-disease-patients-almost-double-compared-aver", "reader_count"=>11, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Researcher"=>2, "Student > Ph. D. Student"=>1, "Other"=>3, "Student > Master"=>2, "Student > Bachelor"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Researcher"=>2, "Student > Ph. D. Student"=>1, "Other"=>3, "Student > Master"=>2, "Student > Bachelor"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>2, "Agricultural and Biological Sciences"=>2, "Medicine and Dentistry"=>3, "Business, Management and Accounting"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Social Sciences"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Social Sciences"=>{"Social Sciences"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Germany"=>1}, "group_count"=>0}

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  • {"files"=>["https://ndownloader.figshare.com/files/2629026"], "description"=>"<p>Bars denote mean excess or deficit.</p>", "links"=>[], "tags"=>["Hepatology Cases", "157 UC inpatients", "K 51 code groups", "IBD care", "coverage analysis", "inpatient care", "CD 2.8 UC 2.4 vs", "type accounting", "cost centers", "CD 44.9 UC 43.3", "CD 11.8 UC 8.4 vs", "CD 6.4 UC 5.2 vs", "endoscopy items", "deficit.ConclusionsDRGs challenge", "CD 7.7 UC 7 vs", "materials budgets", "Average Academic Gastroenterology", "Inflammatory Bowel Disease Patients", "ward personnel", "Academic Inpatient Care", "cost weight", "coverage determinants.ResultsOf", "challenge economies", "cost center", "icd", "balance deficits", "bowel disease", "DRG proceeds"], "article_id"=>1638699, "categories"=>["Biological Sciences"], "users"=>["Daniel C. Baumgart", "Marie le Claire"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0147364.g006", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Ulcerative_Colitis_Cost_type_based_total_coverage_analysis_/1638699", "title"=>"Ulcerative Colitis: Cost type based total coverage analysis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2016-01-28 12:37:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/2629027"], "description"=>"<p>Relation of mean total coverage to gender, patient complexity level (PCCL) and length of stay stratified by Crohn’s disease and ulcerative colitis.</p>", "links"=>[], "tags"=>["Hepatology Cases", "157 UC inpatients", "K 51 code groups", "IBD care", "coverage analysis", "inpatient care", "CD 2.8 UC 2.4 vs", "type accounting", "cost centers", "CD 44.9 UC 43.3", "CD 11.8 UC 8.4 vs", "CD 6.4 UC 5.2 vs", "endoscopy items", "deficit.ConclusionsDRGs challenge", "CD 7.7 UC 7 vs", "materials budgets", "Average Academic Gastroenterology", "Inflammatory Bowel Disease Patients", "ward personnel", "Academic Inpatient Care", "cost weight", "coverage determinants.ResultsOf", "challenge economies", "cost center", "icd", "balance deficits", "bowel disease", "DRG proceeds"], "article_id"=>1638700, "categories"=>["Biological Sciences"], "users"=>["Daniel C. Baumgart", "Marie le Claire"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0147364.g007", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Relation_of_mean_total_coverage_to_gender_patient_complexity_level_PCCL_and_length_of_stay_stratified_by_Crohn_8217_s_disease_and_ulcerative_colitis_/1638700", "title"=>"Relation of mean total coverage to gender, patient complexity level (PCCL) and length of stay stratified by Crohn’s disease and ulcerative colitis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2016-01-28 12:37:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/2629028", "https://ndownloader.figshare.com/files/2629029", "https://ndownloader.figshare.com/files/2629030", "https://ndownloader.figshare.com/files/2629031", "https://ndownloader.figshare.com/files/2629032", "https://ndownloader.figshare.com/files/2629033", "https://ndownloader.figshare.com/files/2629034", "https://ndownloader.figshare.com/files/2629035", "https://ndownloader.figshare.com/files/2629036", "https://ndownloader.figshare.com/files/2629037", "https://ndownloader.figshare.com/files/2629038", "https://ndownloader.figshare.com/files/2629039", "https://ndownloader.figshare.com/files/2629040", "https://ndownloader.figshare.com/files/2629041"], "description"=>"<div><p>Background</p><p>Crohn’s disease (CD) and ulcerative colitis (UC) challenge economies worldwide. Detailed health economic data of DRG based academic inpatient care for inflammatory bowel disease (IBD) patients in Europe is unavailable.</p><p>Methods</p><p>IBD was identified through ICD-10 K50 and K51 code groups. We took an actual costing approach, compared expenditures to G-DRG and non-DRG proceeds and performed detailed cost center and type accounting to identify coverage determinants.</p><p>Results</p><p>Of all 3093 hospitalized cases at our department, 164 were CD and 157 UC inpatients in 2012. On average, they were 44.1 (CD 44.9 UC 43.3 all 58) years old, stayed 10.1 (CD 11.8 UC 8.4 vs. all 8) days, carried 5.8 (CD 6.4 UC 5.2 vs. all 6.8) secondary diagnoses, received 7.4 (CD 7.7 UC 7 vs. all 6.2) procedures, had a higher cost weight (CD 2.8 UC 2.4 vs. all 1.6) and required more intense nursing. Their care was more costly (means: total cost IBD 8477€ CD 9051€ UC 7903€ vs. all 5078€). However, expenditures were not fully recovered by DRG proceeds (means: IBD 7413€, CD 8441€, UC 6384€ vs all 4758€). We discovered substantial disease specific mismatches in cost centers and types and identified the medical ward personnel and materials budgets to be most imbalanced. Non-DRG proceeds were almost double (IBD 16.1% vs. all 8.2%), but did not balance deficits at total coverage analysis, that found medications (antimicrobials, biologics and blood products), medical materials (mostly endoscopy items) to contribute most to the deficit.</p><p>Conclusions</p><p>DRGs challenge sophisticated IBD care.</p></div>", "links"=>[], "tags"=>["Hepatology Cases", "157 UC inpatients", "K 51 code groups", "IBD care", "coverage analysis", "inpatient care", "CD 2.8 UC 2.4 vs", "type accounting", "cost centers", "CD 44.9 UC 43.3", "CD 11.8 UC 8.4 vs", "CD 6.4 UC 5.2 vs", "endoscopy items", "deficit.ConclusionsDRGs challenge", "CD 7.7 UC 7 vs", "materials budgets", "Average Academic Gastroenterology", "Inflammatory Bowel Disease Patients", "ward personnel", "Academic Inpatient Care", "cost weight", "coverage determinants.ResultsOf", "challenge economies", "cost center", "icd", "balance deficits", "bowel disease", "DRG proceeds"], "article_id"=>1638701, "categories"=>["Biological Sciences"], "users"=>["Daniel C. Baumgart", "Marie le Claire"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0147364.s001", "https://dx.doi.org/10.1371/journal.pone.0147364.s002", "https://dx.doi.org/10.1371/journal.pone.0147364.s003", "https://dx.doi.org/10.1371/journal.pone.0147364.s004", "https://dx.doi.org/10.1371/journal.pone.0147364.s005", "https://dx.doi.org/10.1371/journal.pone.0147364.s006", "https://dx.doi.org/10.1371/journal.pone.0147364.s007", "https://dx.doi.org/10.1371/journal.pone.0147364.s008", "https://dx.doi.org/10.1371/journal.pone.0147364.s009", "https://dx.doi.org/10.1371/journal.pone.0147364.s010", "https://dx.doi.org/10.1371/journal.pone.0147364.s011", "https://dx.doi.org/10.1371/journal.pone.0147364.s012", "https://dx.doi.org/10.1371/journal.pone.0147364.s013", "https://dx.doi.org/10.1371/journal.pone.0147364.s014"], "stats"=>{"downloads"=>2, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Expenditures_for_Academic_Inpatient_Care_of_Inflammatory_Bowel_Disease_Patients_Are_Almost_Double_Compared_with_Average_Academic_Gastroenterology_and_Hepatology_Cases_and_Not_Fully_Recovered_by_Diagnosis_Related_Group_DRG_Proceeds_/1638701", "title"=>"The Expenditures for Academic Inpatient Care of Inflammatory Bowel Disease Patients Are Almost Double Compared with Average Academic Gastroenterology and Hepatology Cases and Not Fully Recovered by Diagnosis-Related Group (DRG) Proceeds", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2016-01-28 12:56:26"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2016-01-01T00:00:00Z", "end_date"=>"2016-12-31T00:00:00Z", "subject_areas"=>[]}
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