Hospital nursing costs, billing, and reimbursement.
Nursing intensity, estimated direct nursing costs, and daily billing were compared for 12 adult medical or surgical units at an academic medical center from January 1 to May 31, 2005 (22,649 patient days). Two main findings, nursing intensity and direct nursing costs, were highly variable within and across each of the study nursing units (mean 429 dollars, SD 160 dollars); direct costs of nursing care were significantly higher for private room rates compared to intermediate room per diem charges billed at a higher rate (441 dollars vs. 426 dollars, F 37.77, p < 0.001). The results demonstrate that the direct costs of nursing care are not aligned with current billing practices at this university hospital. The use of fixed room and board charges to account for nursing care in U.S. hospitals may be obsolete and an alternative nurse-centric costing, billing, and reimbursement model is proposed.
Welton
John M
JM
College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
Fischer
Mary Hughes
MH
DeGrace
Sharon
S
Zone-Smith
Laurie
L
D000046:Academic Medical Centers / Q000191:economics; D019538:Health Care Surveys; D017722:Hospital Charges / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006757:Hospital Units / Q000191:economics / Q000458:organization & administration; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009738:Nursing Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D010362:Patients' Rooms / Q000191:economics* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013022:South Carolina; D016526:Workload / Q000191:economics