Spanish Hospital Cost Network Database: building a national benchmark from cost accounting practices

Area of Science:

• Health Economics
• Healthcare Management
• Health Services Research

Background:

• Accurate cost information is critical for healthcare management decisions, including service pricing, benchmarking, and economic evaluations of health technologies and policies.
• Identifying reliable sources for cost data remains a significant challenge in the healthcare sector.
• The Spanish Hospital Cost Network Database (RECH) was developed to address this need by providing comprehensive cost data.

Purpose of the Study:

• To describe the characteristics of the Spanish Hospital Cost Network Database (RECH).
• To outline the underlying cost accounting criteria used in the RECH database.
• To present the methodologies underpinning the RECH project.

Main Methods:

• The database includes episode-level cost information from 34 Spanish hospitals, representing 11% of the Spanish National Health System in 2021.
• Data comprises 4,788,080 episodes collected since 2008, with each episode described by clinical, administrative, and cost variables.
• Key assumptions include full costs, a combination of top-down and bottom-up micro-costing, and Time-Driven Activity-Based Cost allocation.

Main Results:

• The primary output of the RECH dataset is the distribution of costs for user-defined episodes of care.
• Cost statistics, length of stay, and cost component details are provided for six example episodes: Breast cancer surgery, Child delivery, Coronary artery bypass, Covid-19, Hip replacement, and Inguinal hernia surgery.
• Methodological assumptions align with those of the HealthBASKET and EuroDRG projects.

Conclusions:

• The RECH dataset offers valuable, freely available cost statistics for healthcare management and economic evaluations.
• The methodologies employed ensure consistency and comparability with international projects.
• The study highlights the importance of robust cost information systems for informed healthcare decision-making.