Please use this identifier to cite or link to this item:
https://doi.org/10.21256/zhaw-4885
Publication type: | Article in scientific journal |
Type of review: | Peer review (publication) |
Title: | Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study |
Authors: | Eichler, Klaus Hess, Sascha Chmiel, Corinne Bögli, Karin Sidler, Patrick Senn, Oliver Rosemann, Thomas Brügger, Urs |
DOI: | 10.21256/zhaw-4885 10.1136/emermed-2013-202760 |
Published in: | Emergency Medicine Journal |
Volume(Issue): | 31 |
Issue: | 10 |
Page(s): | 818 |
Pages to: | 823 |
Issue Date: | 2014 |
Publisher / Ed. Institution: | BMJ Publishing Group |
ISSN: | 1472-0205 1472-0213 |
Language: | English |
Subject (DDC): | 362.11: Hospitals and related institutions |
Abstract: | Background: Emergency departments (EDs) are increasingly overcrowded by walk-in patients. However, little is known about health-economic consequences resulting from long waiting times and inefficient use of specialised resources. We have evaluated a quality improvement project of a Swiss urban hospital: In 2009, a triage system and a hospital-associated primary care unit with General Practitioners (H-GP-unit) were implemented beside the conventional hospital ED. This resulted in improved medical service provision with reduced process times and more efficient diagnostic testing. We now report on health-economic effects. Methods: From the hospital perspective, we performed a cost comparison study analysing treatment costs in the old emergency model (ED, only) versus treatment costs in the new emergency model (triage plus ED plus H-GP-unit) from 2007 to 2011. Hospital cost accounting data were applied. All consecutive outpatient emergency contacts were included for 1 month in each follow-up year. Results The annual number of outpatient emergency contacts increased from n=10 440 (2007; baseline) to n=16 326 (2011; after intervention), reflecting a general trend. In 2007, mean treatment costs per outpatient were €358 (95% CI 342 to 375). Until 2011, costs increased in the ED (€423 (396 to 454)), but considerably decreased in the H-GP-unit (€235 (221 to 250)). Compared with 2007, the annual local budget spent for treatment of 16 326 patients in 2011 showed cost reductions of €417 600 (27 200 to 493 600) after adjustment for increasing patient numbers. Conclusions: From the health-economic point of view, our new service model shows ‘dominance’ over the old model: While quality of service provision improved (reduced waiting times; more efficient resource use in the H-GP-unit), treatment costs sustainably decreased against the secular trend of increase. |
URI: | https://digitalcollection.zhaw.ch/handle/11475/12829 |
Fulltext version: | Published version |
License (according to publishing contract): | CC BY-NC 3.0: Attribution - Non commercial 3.0 Unported |
Departement: | School of Management and Law |
Organisational Unit: | Winterthur Institute of Health Economics (WIG) |
Appears in collections: | Publikationen School of Management and Law |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
2014_Eichler_Sustained_health-economic_effects_after_reorganisation.pdf | 1.2 MB | Adobe PDF | View/Open |
Show full item record
Eichler, K., Hess, S., Chmiel, C., Bögli, K., Sidler, P., Senn, O., Rosemann, T., & Brügger, U. (2014). Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study. Emergency Medicine Journal, 31(10), 818–823. https://doi.org/10.21256/zhaw-4885
Eichler, K. et al. (2014) ‘Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study’, Emergency Medicine Journal, 31(10), pp. 818–823. Available at: https://doi.org/10.21256/zhaw-4885.
K. Eichler et al., “Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study,” Emergency Medicine Journal, vol. 31, no. 10, pp. 818–823, 2014, doi: 10.21256/zhaw-4885.
EICHLER, Klaus, Sascha HESS, Corinne CHMIEL, Karin BÖGLI, Patrick SIDLER, Oliver SENN, Thomas ROSEMANN und Urs BRÜGGER, 2014. Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study. Emergency Medicine Journal. 2014. Bd. 31, Nr. 10, S. 818–823. DOI 10.21256/zhaw-4885
Eichler, Klaus, Sascha Hess, Corinne Chmiel, Karin Bögli, Patrick Sidler, Oliver Senn, Thomas Rosemann, and Urs Brügger. 2014. “Sustained Health-Economic Effects after Reorganisation of a Swiss Hospital Emergency Centre : A Cost Comparison Study.” Emergency Medicine Journal 31 (10): 818–23. https://doi.org/10.21256/zhaw-4885.
Eichler, Klaus, et al. “Sustained Health-Economic Effects after Reorganisation of a Swiss Hospital Emergency Centre : A Cost Comparison Study.” Emergency Medicine Journal, vol. 31, no. 10, 2014, pp. 818–23, https://doi.org/10.21256/zhaw-4885.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.