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In-patient medical resource utilization for high-level cervical spinal cord injury without bone fracture in Taiwan
J-C Tsai1, W-Y Chang, I-H Hsueh
1Department of Nursing, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Insights
Controlling costs for high-level cervical spinal cord injury patients is crucial. This study found hospital type, accreditation, and patient gender significantly impact length of stay and costs.
Area of Science:
- Healthcare Management
- Spinal Cord Injury Research
- Health Economics
Background:
- The National Health Insurance Program in Taiwan has seen rising costs since 1995.
- High-level cervical spinal cord injury represents a significant financial burden due to extensive medical resource utilization.
- Effective cost-containment policies are necessary to manage healthcare expenditures for these patients.
Purpose of the Study:
- To analyze factors influencing healthcare costs for in-patient cervical spinal cord injury patients.
- To inform the Bureau of National Health Insurance (BNHI) in establishing cost-containment strategies.
- To conserve healthcare resources by understanding cost drivers.
Main Methods:
- Retrospective review of secondary data from the Bureau of National Health Insurance (BNHI).
- Analysis of in-patient expenses for cervical spinal cord injury (ICD-9 codes 952.00-952.03) from 1998-2000.
- Inclusion of 184 hospital admission records from healthcare institutions across Taiwan.
Main Results:
- Significant variations in length of stay and in-patient costs were observed across different hospital types.
- Patient demographics (gender, age) and hospital accreditation level influenced length of stay and costs.
- Patient age was a determining factor for medical orders.
Conclusions:
- Establishment of standardized diagnostic and therapeutic protocols for high-level spinal cord injury without fractures is recommended.
- Implementing these guidelines can meet patient needs while preventing overuse of medical resources.
- Enhancing communication among healthcare providers is essential for optimal patient care and resource management.
Study Design:
Retrospective review of secondary data obtained from the Bureau of National Health Insurance (BNHI) on medical resource utilization in in-patient cervical spinal cord injury patients in Taiwan.
Objectives:
Since the start of the National Health Insurance Program in Taiwan in 1995, costs have continued to increase each year. High-level cervical spinal cord injury, a catastrophic illness, consumes a large amount of medical resources. Appropriate control of in-patient costs for these patients is mandatory. Analyses of the factors influencing the health-care costs of these patients are needed, so cost-containment policies can be established by the BNHI to conserve health-care resources.
Setting:
Health-care institutions throughout Taiwan.
Methods:
We obtained secondary data on a randomized basis for diagnostic codes 952.00, 952.01, 952.02, or 952.03 of the International Classification of Diseases, Ninth Revision, Clinical Modification from the BNHI files of annual in-patient expenses during the period from 1998 to 2000. There were 184 hospital admission records studied.
Results:
The lengths of stay and in-patient costs were significantly different among different hospital types. Length of stay also was statistically different according to patient, gender, and age. The lengths of stay and in-patient costs were influenced by the hospital accreditation level and patient gender. Medical orders were influenced by patient age.
Conclusions:
Basic and selective diagnostics and therapeutics for high-level spinal cord injury without bone fracture should be established. Thus, patient needs for appropriate medical care will be met and overuse of medical resources will be prevented. Communication among doctors also should be strengthened.