Analysis of high cost outliers in a Polish reference hospital

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dc.contributor.authorCyganska, Malgorzata
dc.contributor.otherEkonomická fakultacs
dc.date.accessioned2017-12-20
dc.date.available2017-12-20
dc.date.issued2017-12-20
dc.description.abstractThe growing financial problems of healthcare institutions contribute to the search of methods in properly distributing and clearly justifying resources. One of these is detecting outliers accounting for an important share of hospital costs. The aim of the study is to identify the factors facilitating identification of cost outliers in one of the Polish reference hospitals in northeast Poland. We have analyzed 4,570 patients. Cost analysis was done retrospectively using accountancy and statistical data from the hospital. To select the outliers, we used the interquartile method using the median and the interquartile distance. To evaluate the factors that influence the patient being a cost outlier, we considered: age, length of stay, gender, type of admission, reason of discharge, and type of department. Univariate analysis and multivariable logistic regression were used in the study. Our study revealed that the small percentage of the patients is responsible for the significant level of costs. The total cost outliers comprised 9% of the study sample. They accounted for almost 37% of total hospital costs, 40% of direct costs, and 34% of indirect costs. We discovered that age, gender, length of stay, reason of discharge, and type of department has a significant influence on being the cost outlier. The study revealed that the probability of being the CO increased more than 6 times for the surgical patients. This is consistent with the analysis of CO by ICD 10. The analysis revealed that almost all patients suffered from diseases related to high proportion of CO, required surgery treatment. It is concluded that identifying the cost outliers can contribute to better knowledge by managers about the nature of the costs outliers and can be especially valuable in the financing systems where high costs outliers are separately paid.en
dc.formattext
dc.format.extent11 stran
dc.identifier.doi10.15240/tul/001/2017-4-005
dc.identifier.eissn2336-5604
dc.identifier.issn1212-3609
dc.identifier.urihttps://dspace.tul.cz/handle/15240/21379
dc.language.isoen
dc.publisherTechnical university of Liberec, Czech Republicen
dc.publisherTechnická Univerzita v Libercics
dc.publisher.abbreviationTUL
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dc.relation.ispartofEkonomie a Managementcs
dc.relation.ispartofEconomics and Managementen
dc.relation.isrefereedtrue
dc.rightsCC BY-NC
dc.subjectdirect costsen
dc.subjectindirect costsen
dc.subjectcost outliersen
dc.subjecthospital managementen
dc.subject.classificationI150
dc.subject.classificationM410
dc.titleAnalysis of high cost outliers in a Polish reference hospitalen
dc.typeArticleen
local.accessopen
local.citation.epage69
local.citation.spage59
local.facultyFaculty of Economics
local.fulltextyes
local.relation.abbreviationE+Mcs
local.relation.abbreviationE&Men
local.relation.issue4
local.relation.volume20
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