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Costs of unstructured investigation of unexplained syncope: insights from a micro-costing analysis of the observational PICTURE registry.

Edvardsson N, Wolff C, Tsintzos S, Rieger G, Linker NJ - Europace (2015)

Bottom Line: In the 12% of patients with types of tests entirely within the recommendations for an initial evaluation before ILR implant, the mean cost was £710.Important opportunities to reduce test-related costs before an ILR implant were identified, e.g. by more appropriate use of tests recommended in the initial evaluation, by decreasing repetition of tests, and by avoiding early use of specialized and expensive tests.A structured multidisciplinary approach would be the best model to achieve an optimal outcome.

View Article: PubMed Central - PubMed

Affiliation: Sahlgrenska Academy at Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden nils.g.edvardsson@telia.com.

No MeSH data available.


Related in: MedlinePlus

The five cost components of a diagnostic test are shown using the example of a standard ECG.
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EUU412F1: The five cost components of a diagnostic test are shown using the example of a standard ECG.

Mentions: The micro-costing study of each individual test was based on a combination of existing hospital costs and original data collection. For each test, direct and indirect costs as well as overhead costs were calculated. This involved building an understanding of the typical process of conducting a diagnostic test as well as the associated level of direct resource input regarding the level of direct staff input based on the staff grade and time spent on the key tasks within a standard procedure, any relevant consumables, e.g. drugs and ECG electrodes, and the equipment used. Five cost components were identified (Figure 1): (i) labour (direct pay costs). A 21% on-cost was added to reflect national insurance and superannuation contributions, unless otherwise stated. (ii) Materials and disposables (direct non-pay costs). (iii) Departmental overheads (indirect departmental costs). (iv) Capital equipment costs including direct clinical equipment such as machinery (e.g. the ECG machine, CT scan, etc.). To understand depreciation and maintenance costs, the following formula was used: average cost per test = annual depreciation or maintenance cost/total no. of tests per annum. (v) Corporate overhead costs were added based on the current level of contribution required within the hospital, which according to the selected hospital finance department was 30%. This contribution covered the rates, rents, and other corporate functions such as finance, human resources, and information technology, and was comparable to the percentage of other NHS hospitals. The cost of MRI/CT was calculated as half the sum of an MRI and a CT, since the study data did not differentiate between the two and we do not know the proportion of MRI and CT.Figure 1


Costs of unstructured investigation of unexplained syncope: insights from a micro-costing analysis of the observational PICTURE registry.

Edvardsson N, Wolff C, Tsintzos S, Rieger G, Linker NJ - Europace (2015)

The five cost components of a diagnostic test are shown using the example of a standard ECG.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482287&req=5

EUU412F1: The five cost components of a diagnostic test are shown using the example of a standard ECG.
Mentions: The micro-costing study of each individual test was based on a combination of existing hospital costs and original data collection. For each test, direct and indirect costs as well as overhead costs were calculated. This involved building an understanding of the typical process of conducting a diagnostic test as well as the associated level of direct resource input regarding the level of direct staff input based on the staff grade and time spent on the key tasks within a standard procedure, any relevant consumables, e.g. drugs and ECG electrodes, and the equipment used. Five cost components were identified (Figure 1): (i) labour (direct pay costs). A 21% on-cost was added to reflect national insurance and superannuation contributions, unless otherwise stated. (ii) Materials and disposables (direct non-pay costs). (iii) Departmental overheads (indirect departmental costs). (iv) Capital equipment costs including direct clinical equipment such as machinery (e.g. the ECG machine, CT scan, etc.). To understand depreciation and maintenance costs, the following formula was used: average cost per test = annual depreciation or maintenance cost/total no. of tests per annum. (v) Corporate overhead costs were added based on the current level of contribution required within the hospital, which according to the selected hospital finance department was 30%. This contribution covered the rates, rents, and other corporate functions such as finance, human resources, and information technology, and was comparable to the percentage of other NHS hospitals. The cost of MRI/CT was calculated as half the sum of an MRI and a CT, since the study data did not differentiate between the two and we do not know the proportion of MRI and CT.Figure 1

Bottom Line: In the 12% of patients with types of tests entirely within the recommendations for an initial evaluation before ILR implant, the mean cost was £710.Important opportunities to reduce test-related costs before an ILR implant were identified, e.g. by more appropriate use of tests recommended in the initial evaluation, by decreasing repetition of tests, and by avoiding early use of specialized and expensive tests.A structured multidisciplinary approach would be the best model to achieve an optimal outcome.

View Article: PubMed Central - PubMed

Affiliation: Sahlgrenska Academy at Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden nils.g.edvardsson@telia.com.

No MeSH data available.


Related in: MedlinePlus