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Specialty-specific admission: a cost-effective intervention?

E Slattery¹, G C Harewood

¹Department of Gastroenterology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. Slattery.eoin@gmail.com

Irish Journal of Medical Science

|September 23, 2011

Summary

Specialty-specific admissions for gastroenterology (GI) patients reduce hospital length of stay (LOS) and patient level costing (PLC). This approach appears cost-effective and may improve clinical outcomes.

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Area of Science:

Healthcare Management
Gastroenterology
Health Economics

Background:

Healthcare cost-effectiveness is crucial for service delivery.
Assessing current practices for financial savings is essential.
Specialty-specific admissions can improve clinical outcomes and reduce costs.

Purpose of the Study:

To analyze the cost-effectiveness of specialty-specific admissions in gastroenterology.
To compare length of stay (LOS) and patient-level costing (PLC) for specialty vs. non-specialty admissions.
To identify variations in LOS and PLC within gastroenterology diagnoses.

Main Methods:

Retrospective analysis of gastroenterology (GI) patients admitted to an Irish teaching hospital over two years.
Classification of GI illness using the Disease-Related Grouping (DRG) system.
Calculation of mean LOS and PLC, with comparisons between specialty and non-specialty admissions for common DRGs.

Main Results:

Significant variations in LOS and PLC were observed across DRGs.
Mean LOS ranged from 3.2 days (non-complex GI hemorrhage) to 14.4 days (complex alcohol-related cirrhosis).
Specialty-specific admission was linked to shorter LOS for most GI cases, independent of case complexity.

Conclusions:

Substantial disparities in LOS and PLC exist for most GI diagnoses.
Specialty-specific admissions are associated with reduced LOS.
Specialty-specific admissions appear cost-effective and may enhance clinical outcomes.