F1 Rapid Fire: Making Sense of Health Care Dollars - S. Raschka

289 views

Published on

Published in: Technology, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
289
On SlideShare
0
From Embeds
0
Number of Embeds
67
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

F1 Rapid Fire: Making Sense of Health Care Dollars - S. Raschka

  1. 1. Health Economic Evaluation of Quality and Patient Safety within an Organization Stefanie Raschka Graduate Student, University of Cologne Quality Forum 2012 Breakout Session F1 March, 9th 2012
  2. 2. Agenda1. Background2. Methods3. Results4. Discussion 2
  3. 3. Agenda1. Background2. Methods3. Results4. Discussion 3
  4. 4. 1. BackgroundHealth Economic Evaluation of infection prevention and control programsEconomic burden of selected healthcare acquired infections Efficiency?Identification of potential for greatest financial benefits, further Economic outcomeimprovements, and priority setting by reducing healthcare in a healthcareacquired infections environment?Evaluation of efficiency of regional quality and patient Is it worth it?safety initiatives 4
  5. 5. Agenda1. Background2. Methods3. Results4. Discussion 5
  6. 6. 2. Methods2.1 Health Economic EvaluationHealth Economic Evaluation•Competition between resource scarcity and the best healthcare for the population•Economic outcome measurement, efficient use of resources,•Patient focused Cost-Effectiveness Cost-Benefit Analysis Cost-Utility Analysis Analysis • Comparative study• Evaluation of costs design by using • Comparative study and consequences in monetary and non- design by using monetary units monetary units monetary and non- • Benefits = natural monetary units Is an intervention units (e.g. hospital • Outcome worthwhile? days prevented) measurement in a • Costs = monetary unit of utility units Eg. Quality adjusted • Evaluation of different life years (QALY) drug therapies 6
  7. 7. 2. Methods2.2 Determining costs and benefits 2.Cost/Benefit-Calculation: • Exact changes of infection rates from a moving baseline • Two cost categories: a) Cost for the treatment of selected HAIs & b) Costs for infection prevention and control (IPC) programs • “Savings” = Cost avoidance from  infections • Cost benefit a) Costs for each selected HAI – the cost avoidance for that HAI category b) Cost of the IPC program - Cost avoidance from  infections 7
  8. 8. 2. Methods2.3 Selected Healthcare Acquired Infections 2. Organizational Perspective: • Calculations are based on internal data • Limited availability of data  no disease specific cost data available 3. Meta-Analysis: • (Inter-) National studies and data as benchmarks • e.g. PICNet, IHI, CPSI, CNISP • PICNet Business case was used (as available) for estimated cost per infection, adjusted costs to 2010/11 using an annual inflation factor of 3% per year 4. Selection of Projects: • Only a few of the overall infection prevention and control programs undertaken by the QPS Department were analyzed • MRSA, UTI, CDI, VRE, Healthcare acquired Bacteremias, SSI • Only nosocomial incidence cases have been taken into analysis 8
  9. 9. Agenda1. Background2. Methods3. Results4. Discussion 9
  10. 10. 3. Results3.1 Evaluation of Costs Overall Expenditures on HAIs at VCH over the last four years 19 18.15 18 Expenditures in $ M. 18.21 17 15.59 16 15 14 13 13.26 12 2007-08 2008-09 2009-10 2010-11 VCH spent more than $ 65.2 M for the treatment of the selected HAIs over the last 4 years 10
  11. 11. 3. Results3.1 Evaluation of Costs UTI is the most common HAI at VCH with 18,900 cases over the last 4 years 11
  12. 12. 3. Results3.1 Evaluation of Costs UTI, VRE, Bacteremia and MRSA are the main cost drivers 12
  13. 13. 3. Results3.1 Evaluation of Costs The total expenditures for the QPS Department were more than $ 11 M and $ 6.7 M for Infection Control over the last four years The increased QPS costs reflect program expansion. 13
  14. 14. 3. Results3.2 Evaluation of “Savings” VCH was able to generate overall “savings” of $ 8 M over the last 4 years 14
  15. 15. 3. Results3.2 Evaluation of Savings 46 % of overall savings have been generated by reducing UTI cases 15
  16. 16. 3. Results3.3 Overall Cost-Benefit Analysis UTI, VRE, MRSA and Bacteremia have the most potential for further benefits 16
  17. 17. 3. Results3.3 Overall Cost-Benefit Analysis SSIs, BSIs, MRSA and VRE have been identifies as the most expensive HAIs 17
  18. 18. 3. Results3.3 Overall Cost-Benefit Analysis of the IPCprogram The overall savings by reducing the selected HAIs exceed the costs for infection prevention and control initiatives 18
  19. 19. 3. Results3.3 Overall Cost-Benefit Analysis A break-even point of costs and savings was realized in the second year of evaluation 19
  20. 20. Agenda1. Background2. Methods3. Results4. Discussion 20
  21. 21. 4. Discussion  Costs of $ 65 M for the treatment of the selected HAIs over a four year evaluation periodEconomic burden  Costs of $ 11.2 M QPS / $ 6.7 M IPC compared to saving of $ 8.1 M by reducing 4,700 HAI cases  Break-even in the second year of evaluation  Potential priority setting on UTI, VRE, MRSA and Bacteremias Potential and Priorities  Extension of initiatives to all facilities (rural)  Creation of further incentives to increase compliance rates  Availability and validity of data  Collaborative team approach for quality Limitations and patient safety initiatives  Overall organizational benefit 21
  22. 22. Thank you! Contact Information: S.Raschka@gmail.com 22
  23. 23. Collaborators• Linda Dempster• Shane Busby• Elizabeth Bryce• Patrick O’Connor• Leslie Forrester• Catherine Pacero• Mark Chase

×