Rösch Margrit, Leidl Reiner, Thomas Stefanie, von Tirpitz Christian, Reinshagen Max, Adler Guido, König Hans-Helmut
Abteilung Gesundheitsökonomie, Medizinische Universitäts- und Poliklinik, Universität Ulm.
Med Klin (Munich). 2002 Mar 15;97(3):128-36. doi: 10.1007/s00063-002-1136-x.
To create a concept for measuring and valuating resource utilization of outpatient treatment of patients with inflammatory bowel disease in a German university hospital.
The measurement of health services was achieved using a computer-based routinely administered data base of the Medical Department. Measuring costs was performed in three steps: 1. identification of the categories of resource utilization, 2. quantitative measurement of resource use, 3. monetary valuation of the utilization of resources using German fee schedules and prices for drugs.
The resource utilization of 272 patients with a treatment period of more than 1 year could be identified in a structured form. Categories of resource use could be identified and quantitatively measured as follows: anamnesis and physical examination by a physician in 100% of the visits, laboratory tests in 87.1%, endoscopic or sonographic services in 36.9%, and radiologic procedures in 14.1%. In 93.6% of the visits a medication was prescribed. Annual costs of outpatient care provided by the hospital were 3,171 [symbol: see text] per patient. Medication accounted for 85% of total costs. Analyzing the costs of medical treatment, mesalazine was the major cost component (48%), followed by budesonide (15%).
The presented concept offers a good access to measure costs of outpatient treatment of patients with inflammatory bowel disease. It is suitable for measuring costs in the economic evaluation of alternative treatments or diagnostic strategies in an outpatient setting. It furthermore may be used as a component in cost-of-illness studies. For transferring the concept to other hospitals, the availability of a routine documentation of services should be checked. For economic analysis, a further data management is required.
为德国一家大学医院的炎症性肠病患者门诊治疗资源利用的测量和评估创建一个概念。
利用医学部基于计算机的常规管理数据库实现卫生服务的测量。成本测量分三步进行：1. 确定资源利用类别；2. 资源使用的定量测量；3. 使用德国收费标准和药品价格对资源利用进行货币估值。
可以以结构化形式确定272名治疗期超过1年的患者的资源利用情况。资源使用类别可确定并定量测量如下：100%的就诊中有医生进行问诊和体格检查，87.1%进行实验室检查，36.9%进行内镜或超声检查，14.1%进行放射学检查。93.6%的就诊中开具了药物。医院提供的门诊护理年度成本为每位患者3,171欧元。药物占总成本的85%。分析医疗治疗成本，美沙拉嗪是主要成本组成部分（48%），其次是布地奈德（15%）。
所提出的概念为测量炎症性肠病患者门诊治疗成本提供了良好途径。它适用于在门诊环境中对替代治疗或诊断策略的经济评估中测量成本。此外，它还可作为疾病成本研究的一个组成部分。为了将该概念应用于其他医院，应检查服务常规记录的可用性。对于经济分析，还需要进一步的数据管理。
