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[Cost analysis of radiological interventional procedures and reimbursement within a clinic]
M Strotzer1, M Völk, M Lenhart
1Institut für Radiologische Diagnostik, Klinikum der Universität Regensburg, Germany.
Insights
Vascular radiological intervention costs significantly exceed reimbursement from GOA (Gebührenordnung für Arzte) and DKG-NT (Deutsche Krankenhausgesellschaft-Nebenkostentarif) fee schedules. This analysis reveals substantial deficits, impacting hospital financial management.
Area of Science:
- Radiology
- Health Economics
Context:
- Vascular radiological interventions are crucial procedures.
- Accurate cost analysis is vital for hospital financial health.
- Existing reimbursement structures may not reflect actual costs.
Purpose:
- To analyze per-patient costs of vascular radiological interventions.
- To compare these costs against reimbursement from GOA and DKG-NT fee schedules.
- To assess the economic viability of these procedures under current reimbursement.
Summary:
- A study of 832 interventional procedures found significant discrepancies between calculated costs and reimbursement.
- The ten most frequent procedures resulted in deficits of 1.06 million DM (GOA) and 0.787 million DM (DKG-NT).
- Reimbursement covered only 34.2% (GOA) and 51.3% (DKG-NT) of the costs.
Impact:
- Current reimbursement models (GOA, DKG-NT) are insufficient for effective economic controlling in hospitals.
- Hospitals face financial deficits in vascular interventional radiology.
- This highlights a need for revised reimbursement strategies to ensure financial sustainability.
Purpose:
Analysis of costs for vascular radiological interventions on a per patient basis and comparison with reimbursement based on GOA (Gebührenordnung für Arzte) and DKG-NT (Deutsche Krankenhausgesellschaft-Nebenkostentarif).
Material And Methods:
The ten procedures most frequently performed within 12 months were evaluated. Personnel costs were derived from precice costs per hour and estimated procedure time for each intervention. Costs for medical devices were included. Reimbursement based on GOA was calculated using the official conversion factor of 0.114 DM for each specific relative value unit and a multiplication factor of 1.0. The corresponding conversion factor for DKG-NT, determined by the DKG, was 0.168 DM.
Results:
A total of 832 interventional procedures were included. Marked differences between calculated costs and reimbursement rates were found. Regarding the ten most frequently performed procedures, there was a deficit of 1.06 million DM according GOA data (factor 1.0) and 0.787 million DM according DKG-NT. The percentage of reimbursement was only 34.2 (GOA; factor 1.0) and 51.3 (DKG-NT), respectively.
Conclusion:
Reimbursement of radiological interventional procedures based on GOA and DKG-NT data is of limited value for economic controlling purposes within a hospital.