Universität zu Köln

Jacobs, Volker R., Mayer, Stefanie C., Paessens, Bernadette J., Bernard, Rudolf, Harbeck, Nadia, Kiechle, Marion and Ihbe-Heffinger, Angela (2011). Comparison of Actual Hospital Costs versus DRG Revenues for In-Patient Treatment of Febrile Neutropenia during Adjuvant Anthracycline plus/minus Taxane-Based Chemotherapy for Primary Breast Cancer. Onkologie, 34 (11). S. 614 - 619. BASEL: KARGER. ISSN 1423-0240

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Abstract

Background: In flat-rate reimbursement systems, the hospital's own costs should not exceed its revenues. In a cohort of primary breast cancer (pBC) patients, costs and reimbursement for febrile neutropenia (FN) were compared to verify cost coverage. Methods: A prospective, observational study in pBC patients receiving adjuvant anthracycline +/- taxane-based chemotherapy calculated the costs per in-patient FN episode. The correlating revenues were retrospectively analyzed from diagnosis-related group (DRG) invoices. The actual costs of the therapies were compared to the individual DRG revenues, and the results are presented from the provider's perspective. Results: In 50 patients, n = 11 patients were treated for FN as in-patients. The hospital's overall treatment costs were (sic) 18,288, on average ((empty set)) (sic) 1663 per case (range (sic) 1139-2344); the overall DRG revenues were (sic) 23,593,(empty set)(sic) 2145 per case (range (sic) 1266-2660). In n = 8 cases, the DRGs were cost covering, and in n = 3 cases, a loss was observed, but overall resulting in a gain of(empty set)(sic) 482 per case and thus being cost covering for the provider. Inadequate DRG coding (n = 4/11; 36.4%) resulted in a preventable loss of(empty set)(sic) 1069/case. Conclusions: The costs of FN treatment vary substantially and DRG reimbursements do not necessarily reflect the provider's costs. Surprisingly, the in-patient treatment of FN here is overall more than cost covering if adequately coded. The main reasons are asymmetrical costs for this FN low-risk pBC group. These results emphasize the importance of correct medical coding to avoid potential losses.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jacobs, Volker R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mayer, Stefanie C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Paessens, Bernadette J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bernard, Rudolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Harbeck, Nadia UNSPECIFIED UNSPECIFIED UNSPECIFIED Kiechle, Marion UNSPECIFIED UNSPECIFIED UNSPECIFIED Ihbe-Heffinger, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-486162
DOI:	10.1159/000334063
Journal or Publication Title:	Onkologie
Volume:	34
Number:	11
Page Range:	S. 614 - 619
Date:	2011
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1423-0240
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LYMPHOPROLIFERATIVE DISORDERS; ONCOLOGICAL THERAPIES; PHARMACEUTICAL COSTS; OUTPATIENT TREATMENT; LUNG-CANCER; G-CSF; MANAGEMENT; CARE; REDUCE; COMPLICATIONS Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48616