title: Costs of measuring outcomes of acute hospital care in a longitudinal outcomes measurement system.
abstract: It is widely acknowledged that the measurement of outcomes of care and the comparison of outcomes over time within health care providers and risk-adjusted comparisons among providers are important parts of improving quality and cost-effectiveness of care. However, few studies have assessed the costs of measuring outcomes of care. We sought to evaluate the personnel and financial resources spent for a prospective assessment of outcomes of acute hospital care by health professionals in internal medicine. The study included 15 primary care hospitals participating in a longitudinal outcomes measurement program and 2005 patients over an assessment period with an average duration of 6 months. Each hospital project manager participated in a previously-tested structured 30-minute telephone interview. Outcome measures include time spent by the individual job titles in implementing and running the outcomes measurement program. Job-title-specific times were used to calculate costs from the hospitals' perspective. One-time costs (2132 +/- 1352 Euros) and administrative costs (95 +/- 97 Euros per week) varied substantially. Costs per patient were fairly stable at around 20 Euros. We estimated that the total cost for each hospital to assess outcomes of care for accreditation (10 tracer diagnoses over 6 months) would be 9700 Euros and that continuous monitoring of outcomes (5 tracer diagnoses) would cost 12,400 Euros per year. This study suggests that outcomes of acute hospital care can be assessed with limited resources and that standardized training programs would reduce variability in overall costs. This study should help hospital decision makers to estimate the necessary funding for outcomes measurement initiatives.
authors.affiliation: Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass 02115, USA. schneeweiss@post.harvard.edu
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schneeweiss
authors.forename: Astrid
authors.initials: A
authors.lastname: Manstetten
authors.forename: Manfred
authors.initials: M
authors.lastname: Wildner
authors.forename: Oliver
authors.initials: O
authors.lastname: Sangha
authors.forename: Michael
authors.initials: M
authors.lastname: Liebetrau
authors.forename: Axel
authors.initials: A
authors.lastname: Paeger
mesh_terms: D017721:Hospital Costs / Q000706:statistics & numerical data*; D006748:Hospital Departments / Q000191:economics / Q000592:standards*; D006801:Humans; D007318:Inservice Training / Q000191:economics; D007388:Internal Medicine / Q000191:economics / Q000592:standards*; D007902:Length of Stay; D008137:Longitudinal Studies; D017063:Outcome Assessment, Health Care / Q000191:economics* / Q000379:methods; D010561:Personnel Staffing and Scheduling / Q000191:economics; D020379:Risk Adjustment; D013997:Time Factors; D014481:United States; D014600:Utilization Review / Q000191:economics