title: [Changing the internal cost allocation (ICA) on DRG shares : Example of computed tomography in a university radiology setting].
abstract: BACKGROUND
  In hospitals, the radiological services provided to non-privately insured in-house patients are mostly distributed to requesting disciplines through internal cost allocation (ICA). In many institutions, computed tomography (CT) is the modality with the largest amount of allocation credits.
  
  
  OBJECTIVE
  The aim of this work is to compare the ICA to respective DRG (Diagnosis Related Groups) shares for diagnostic CT services in a university hospital setting.
  
  
  METHODS
  The data from four CT scanners in a large university hospital were processed for the 2012 fiscal year. For each of the 50 DRG groups with the most case-mix points, all diagnostic CT services were documented including their respective amount of GOÄ allocation credits and invoiced ICA value. As the German Institute for Reimbursement of Hospitals (InEK) database groups the radiation disciplines (radiology, nuclear medicine and radiation therapy) together and also lacks any modality differentiation, the determination of the diagnostic CT component was based on the existing institutional distribution of ICA allocations.
  
  
  RESULTS
  Within the included 24,854 cases, 63,062,060 GOÄ-based performance credits were counted. The ICA relieved these diagnostic CT services by € 819,029 (single credit value of 1.30 Eurocent), whereas accounting by using DRG shares would have resulted in € 1,127,591 (single credit value of 1.79 Eurocent). The GOÄ single credit value is 5.62 Eurocent.
  
  
  CONCLUSIONS
  The diagnostic CT service was basically rendered as relatively inexpensive. In addition to a better financial result, changing the current ICA to DRG shares might also mean a chance for real revenues. However, the attractiveness considerably depends on how the DRG shares are distributed to the different radiation disciplines of one institution.
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Wirth
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Zielinski
authors.affiliation: Controlling, Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Trinter
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Stahl
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Mück
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland. Stefan.Wirth@med.uni-muenchen.de.
authors.forename: S
authors.initials: S
authors.lastname: Wirth
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D003361:Cost Allocation / Q000191:economics*; D003953:Diagnosis-Related Groups / Q000191:economics*; D005062:European Union; D005858:Germany; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D011871:Radiology / Q000191:economics*; D014057:Tomography, X-Ray Computed / Q000191:economics*
keywords: Comparative study; Cost allocation; Diagnosis-related groups; Hospital management, hospital; Tomography, spiral computed