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Burn service costing using a mixed model methodology.

Robert T Duncan1, Ken W Dunn1

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|March 23, 2020
PubMed
Summary
This summary is machine-generated.

Accurate patient-level costing is crucial for burn care services. This study reveals that actual burn care costs significantly exceed estimates, highlighting the need for a new costing system to ensure service viability.

Keywords:
Bottom upBurnCostCost analysisMethodologyNHSTop down

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Area of Science:

  • Healthcare economics
  • Burn care management
  • Health services research

Background:

  • The UK National Health Service's "free at the point of delivery" principle is threatened by rising healthcare costs.
  • Current fixed tariff remuneration systems inadequately address the complexity of burn injuries.
  • Accurate cost assessment is vital for the sustainability of specialized services like burn care.

Purpose of the Study:

  • To develop a Patient Level Costing (PLC) system for burn care.
  • To determine the true service-level costs associated with burn injury treatment.
  • To inform healthcare policy and service planning by providing accurate cost data.

Main Methods:

  • Employed a hybrid costing approach, combining Top-Down Costing (hospital budget analysis) and Bottom-Up Costing (detailed itemized costs).
  • Costs were meticulously categorized and allocated to specific care areas within a Burns & Plastic Surgery Department.
  • Analyzed fixed costs by assessing departmental expenses during periods of zero clinical activity.

Main Results:

  • Burn care costs were found to be significantly higher (62%) than initially estimated by the host organization, questioning the reliability of existing cost data.
  • Fixed costs represent a substantial portion (90%) of total operational expenses, even without clinical activity.
  • The study identified significant discrepancies between estimated and actual costs, underscoring the limitations of current costing methodologies.

Conclusions:

  • Implementing a robust Patient Level Costing system is essential for the financial viability of burn services facing remuneration changes.
  • Accurate understanding of healthcare costs supports effective service development and strategic planning at both local and national levels.
  • The developed costing model provides a foundation for iterative refinement and broader application in healthcare cost analysis.