Cost Performance ProfileTM

We believe that the aim of Resource Management is to provide more and better care for a given sum of money. This involves the costing of the activity of the ICU and is generally considered as tedious.

In the United Kingdom, the introduction of the NHS "Internal market" and the use of a national tariff to cost hospital in-patient activities have placed healthcare economics in all aspects of healthcare management, be it at a corporate or departmental level. We view the internal market as a cost-containment measure and its impact will be greatly felt in all aspects of healthcare.

MASH pioneered the costing of ICU activity in 1988, using the Therapeutic Intervention Scoring System (TISS) as the "cost mechanism".  Our field studies have shown that by relating cost to TISS, TISS can be used as a simple and manageable way to track costs in the ICU.

When TISS is also used as an aid to clinical decision making, Resource Management takes on a completely different light. We can now track the daily cost of treatment for each patient, the resource usage of different categories of patients and even different consultants. For UK hospitals, the CCMDS Healthcare Resource Groups (HRGs) have replaced TISS as the costing mechanism. However, for non-UK hospitals, TISS can be an invaluable costing tool.

The Cost Performance Profile TM, an innovative report developed by MASH will evaluate the cost effectiveness of an ICU by integrating information relating to the number of admissions, the Standardised Mortality Ratio and the cost of treatment including the Effective Cost Per Survivor across the entire spectrum of admission risk. The Cost Performance Profile can also be used to measure the cost-effectiveness of new therapies or new drugs in the ICU. This is a new but more meaningful way to approach resource management in the ICU.

There is a widely held opinion that audit and especially Resource Management is an imposition on the clinician and nursing staff and is irrelevant to the day to day management of patients. The above brief description of our methodology will have alerted the astute reader to the fact that all three major components are based on the same dataset. This is not accidental. It is based on the overall design concept that as healthcare professionals, clinical decision making, clinical audit and resource management are complementary components of an integrated approach to the care of the ICU patient.

Lancet editoral 1988...... the impact of this will be felt in every aspects of medicine
 
canakkale canakkale canakkale truva search