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    Specialty-specific admission: a cost-effective intervention?

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    Authors
    Slattery, E
    Harewood, G C
    Affiliation
    Department of Gastroenterology, Beaumont Hospital, Beaumont Road, Dublin 9,, Ireland, Slattery.eoin@gmail.com.
    Issue Date
    2012-02-01T10:05:12Z
    
    Metadata
    Show full item record
    Citation
    Ir J Med Sci. 2012 Mar;181(1):87-91. Epub 2011 Sep 21.
    Journal
    Irish journal of medical science
    URI
    http://hdl.handle.net/10147/207339
    DOI
    10.1007/s11845-011-0758-5
    PubMed ID
    21938442
    Abstract
    INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.
    Language
    eng
    ISSN
    1863-4362 (Electronic)
    0021-1265 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11845-011-0758-5
    Scopus Count
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    Beaumont Hospital

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