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DOI: 10.1055/s-2005-865677
© Georg Thieme Verlag KG Stuttgart · New York
Cost Unit Accounting Based on a Clinical Pathway: A Practical Tool for DRG Implementation
Publication History
Received February 14, 2005
Publication Date:
06 October 2005 (online)
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Abstract
Setting up a reliable cost unit accounting system in a hospital is a fundamental necessity for economic survival, given the current general conditions in the healthcare system. Definition of a suitable cost unit is a crucial factor for success. We present here the development and use of a clinical pathway as a cost unit as an alternative to the DRG. Elective coronary artery bypass grafting was selected as an example. Development of the clinical pathway was conducted according to a modular concept that mirrored all the treatment processes across various levels and modules. Using service records and analyses the process algorithms of the clinical pathway were developed and visualized with CorelTM iGrafix® Process 2003. A detailed process cost record constituted the basis of the pathway costing, in which financial evaluation of the treatment processes was performed. The result of this study was a structured clinical pathway for coronary artery bypass grafting together with a cost calculation in the form of cost unit accounting. The use of a clinical pathway as a cost unit offers considerable advantages compared to the DRG or clinical case. The variance in the diagnoses and procedures within a pathway is minimal, so the consumption of resources is homogeneous. This leads to a considerable improvement in the value of cost unit accounting as a strategic control instrument in hospitals.
Key words
Cost calculation - cost unit - clinical pathway - cardiac surgery - CABG - DRG
References
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Dr. med. (MBA) Richard Feyrer
Center of Cardiac Surgery
University of Erlangen-Nuremberg
Krankenhausstraße 12
91054 Erlangen
Germany
Phone: + 4991318533217
Fax: + 49 9 13 18 53 60 88
Email: richard.feyrer@herz.imed.uni-erlangen.de