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Cutting costs: the impact of price lists on the cost development at the emergency department
1Akutkliniken, Linköpings University Hospital, Universitetssjukhuset, Sweden. mschillingdeu@netscape.net
Insights
Providing price lists to emergency department physicians significantly reduced investigation costs, particularly for radiology. This study demonstrates price lists are an effective tool for cutting healthcare expenses.
Area of Science:
- Healthcare Management
- Health Economics
- Medical Costs
Background:
- Physicians in Swedish emergency departments (ED) lacked awareness of investigation costs.
- High costs associated with laboratory and radiology investigations in EDs are a concern.
Purpose of the Study:
- To evaluate the impact of price lists on laboratory and radiology costs at a Swedish university hospital's ED.
- To assess if increased cost awareness among physicians reduces healthcare expenditure.
Main Methods:
- Price lists for common ED laboratory and radiological investigations were created and distributed to internal medicine physicians.
- Costs were compared between a group receiving price lists and an orthopaedic control group before and after intervention.
- Statistical analysis used the Student's t-test to compare average costs per patient.
Main Results:
- Medical patient costs decreased by 18.8%, with laboratory costs down 21.4% and radiology costs down 20.59%.
- Orthopaedic patient costs increased slightly by 1.95%, with laboratory costs down 9% and radiology costs up 5.4%.
- Overall investigation costs showed a major decrease, with a significant reduction in radiological expenses.
Conclusions:
- Distribution of price lists effectively heightened physician cost awareness, leading to reduced investigation costs in the emergency department.
- Price lists serve as a practical and effective tool for cost reduction in public healthcare settings.
- Targeted interventions can influence physician behavior and optimize resource utilization in healthcare.
Abstract:
It was shown that physicians working at the Swedish emergency department (ED) are unaware of the costs for investigations performed. This study evaluated the possible impact of price lists on the overall laboratory and radiology costs at the ED of a Swedish university hospital. Price lists including the most common laboratory analyses and radiological investigations at the ED were created. The lists were distributed to all internal medicine physicians by e-mail and exposed above their working stations continually. No lists were provided for the orthopaedic control group. The average costs for laboratory and radiological investigations during the months of June and July 2007 and 2008 were calculated. Neither clinical nor admission procedures were changed. The physicians were blinded towards the study. Statistical analysis was performed using the Student's t-test. A total of 1442 orthopaedic and 1585 medical patients were attended to in 2007. In 2008, 1467 orthopaedic and 1637 medical patients required emergency service. The average costs per patient were 980.27 SKR (98€)/999.41 SKR (100€, +1.95%) for orthopaedic and 1081.36 SKR (108€)/877.3 SKR (88€, -18.8%) for medical patients. Laboratory costs decreased by 9% in orthopaedic and 21.4% in medical patients. Radiology costs changed +5.4% in orthopaedic and -20.59% in medical patients. The distribution and promotion of price lists as a tool at the ED to heighten cost awareness resulted in a major decrease in the investigation costs. A significant decrease in radiological costs could be observed. It can be concluded that price lists are an effective tool to cut costs in public healthcare.
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