[Proposal for optimal use of resources in the hospital treatment of heart failure by an increased utilization of cardiac rehabilitation].
BACKGROUND
Cardiac failure has an important economic weight on social cost. An improved resources utilization could promote a reduction of the new hospitalization and a of medical costs.


OBJECTIVE
To analyze a model of increased utilization of our Cardiac Rehabilitation (CR) Unit, aiming at improving the cost/profit ratio through a better use of resources and a better assignment of care. With a reduction of average length of stay in the Operative Units for acute patients, we could promote a demand of post-acute hospitalization of 950.7 days of hospitalization that could be assigned to Cardiologic Rehabilitation Unit.


RESULTS
With the transfer of patients the utilization rate of CR would increase to 97%. With a mean period in bed of 15.3 days we could hospitalize 62 additional patients and the total margin of contribution would became positive: 69.817 euro. The break even analysis applied to costs and returns of the Unit shows a further indication to increase the hospitalization number in CR Unit with patients transferred from acute patient units. Under the same costs the recovery of efficiency leads to a reduction of variable costs. In the same time there is an increase of returns due to an increase of mean value for case and an increase of services.


CONCLUSIONS
The increase in the efficiency in the utilization of CR Unit leads to an increase of the Hospital efficiency. The transfer of patients from acute units to CR Unit would allow an increased hospitalization rate for acute patients without requiring additional resources.
Diaco
Tommaso
T
U.O. di Riabilitazione Cardiologia, Ospedale S. Marta, Rivolta d'Adda - Azienda Ospedaliera Ospedale Maggiore di Crema.
Milanesi
Geremia
G
Zaniboni
Daniela
D
Gritti
Massimo
M
Zavatteri
Gianna
G
Claus
Marco
M
Velo
Francesco
F
D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D017048:Health Care Costs; D006295:Health Resources / Q000458:organization & administration*; D006333:Heart Failure / Q000191:economics / Q000534:rehabilitation* / Q000628:therapy; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007558:Italy; D007902:Length of Stay / Q000191:economics; D010360:Patient Transfer; D012046:Rehabilitation / Q000706:statistics & numerical data