Ganzoni D, Zellweger R, Trentz O
Departement für Chirurgie, Klinik für Unfallchirurgie, Universitätsspital Zürich.
Swiss Surg. 2003;9(6):268-74. doi: 10.1024/1023-9332.9.6.268.
The rising costs of the Swiss health care system are currently a source of discussion. Precise facts about the treatment costs in Switzerland are not available. The aim of this paper is to assess the price of the acute therapy of multiple trauma patients at the University Hospital of Zurich. We analysed the exact treatment costs of 16 patients with an average Injury Severity Score (ISS) of 33.9. All these cases had a private or a supplementary insurance coverage, were foreigners or were otherwise invoiced according to the so-called hospital tariff (Spitalleistungskatalog/SLK). We developed a concept to measure the expenditure not covered by the insurance of those with a basic insurance, who entail the largest percent of all hospitalized patients. The average amount invoiced was 128,135 Swiss Francs (31,266-310,358 CHF). After subtracting the profit, gained on cases charged according to the SLK, the remaining deficit per ordinary insured was 42-65% or 33,703-138,829 CHF The range of this amount depends on the insurance status of the afflicted person. If hospitals are required to work with a balanced budget, then these losses can no longer be neglected. New forms of invoicing multiply trauma patients must be found in Switzerland.
瑞士医疗保健系统成本的不断上升目前是一个讨论的话题。关于瑞士治疗成本的确切数据并不可得。本文的目的是评估苏黎世大学医院多发伤患者急性治疗的费用。我们分析了16例平均损伤严重度评分(ISS)为33.9的患者的确切治疗成本。所有这些病例都有私人保险或补充保险,是外国人,或者按照所谓的医院收费标准(Spitalleistungskatalog/SLK)开具账单。我们制定了一个概念,用以衡量基本保险患者保险未涵盖的支出,这类患者占所有住院患者的比例最大。开具账单的平均金额为128,135瑞士法郎(31,266 - 310,358瑞士法郎)。减去按照SLK收费的病例所获得的利润后,每位普通参保人的剩余赤字为42% - 65%,即33,703 - 138,829瑞士法郎。这个金额范围取决于患者的保险状况。如果要求医院保持预算平衡,那么这些损失就不能再被忽视。瑞士必须找到给多发伤患者开具账单的新形式。