[Medical and economic evaluation of oncological inpatients in 14 Belgian hospitals].
BACKGROUND
A prospective payment system per DRG is announced in Belgium. Is this kind of financing system adequate for oncology? Objectives of this study are: to analyze medical and economical characteristics of oncological inpatients and evaluate the homogeneity of costs and length of stay per DRG.


METHODS
The study was realized in 14 Belgian hospitals, with 2010 data. Inpatients with primary diagnosis of neoplasms were selected in medical and administrative databases. Characteristics of patients as well as length of stay and cost (hospital perspective) were analyzed. The homogeneity of costs and length of stay is measured by calculating the coefficient of variation (standard deviation divided by the mean).


RESULTS
The length of stay (standard deviation) is 9.72 days (12.64). The variation is high per DRG. The average cost (standard deviation) is 7689.28€ (10,418) and is also variable from one DRG to another one. There are 5% of high-length of stay outliers and 0.2% of low-length of stay outliers. There are 4.7% of high-cost outliers and 0.2% of low-cost outliers. The withdrawal of outliers improves the homogeneity of cost and length of stay per APR-DRG.


CONCLUSIONS
There is a homogeneity of costs and length of stay per DRG and per severity of illness. A prospective payment system per DRG would probably be applicable for these patients. It is however necessary to plan an appropriate and additional financing of all elements susceptible to stimulate innovation in the management of oncology and to stimulate the quality of care by adding financial stimulants.
Université libre de Bruxelles, école de santé publique, centre de recherche en économie de la santé, gestion des institutions de soins et sciences infirmières, 808, route de Lennik, CP592, 1070 Bruxelles, Belgique. Electronic address: magali.pirson@ulb.ac.be.
Magali
M
Pirson
Université libre de Bruxelles, école de santé publique, centre de recherche en économie de la santé, gestion des institutions de soins et sciences infirmières, 808, route de Lennik, CP592, 1070 Bruxelles, Belgique.
Julie
J
Van den Bulcke
Université libre de Bruxelles, école de santé publique, centre de recherche en économie de la santé, gestion des institutions de soins et sciences infirmières, 808, route de Lennik, CP592, 1070 Bruxelles, Belgique.
Lionel
L
Di Pierdomenico
Université libre de Bruxelles, école de santé publique, centre de recherche en économie de la santé, gestion des institutions de soins et sciences infirmières, 808, route de Lennik, CP592, 1070 Bruxelles, Belgique.
Dimitri
D
Martins
Université libre de Bruxelles, école de santé publique, centre de recherche en économie de la santé, gestion des institutions de soins et sciences infirmières, 808, route de Lennik, CP592, 1070 Bruxelles, Belgique.
Pol
P
Leclercq
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics*; D016311:Outliers, DRG; D011445:Prospective Payment System; D012737:Sex Factors
Cost; Coût; DRG; Financement; Financing; Oncologie; Oncology