Ciałkowska-Rysz Aleksandra D, Pokropska Wieslawa, Łuczak Jacek, Kaptacz Anna, Stachowiak Andrzej, Hurich Krystyna, Koszela Monika
Palliative Care Ward, Department of Oncology, Medical University of Lodz, Lodz, Poland.
Elbląg Hospice of Dr. Aleksandra Gabrysiak, Elblag, Poland.
Arch Med Sci. 2016 Apr 1;12(2):457-68. doi: 10.5114/aoms.2016.59272. Epub 2016 Apr 12.
The main task of palliative care units is to provide a dignified life for people with advanced progressive chronic disease through appropriate symptom management, communication between medical specialists and the patient and his family, as well as the coordination of care. Many palliative care units struggle with low incomes from the National Health Fund (NHF), which causes serious economic problems. The aim of the study was to estimate of direct and administrative costs of care and the actual cost per patient per day in selected palliative care units and comparison of the results to the valuation of the NHF.
The study of the costs of hospitalization of 175 patients was conducted prospectively in five palliative care units (PCUs). The costs directly associated with care were recorded on the specially prepared forms in each unit and also personnel and administrative costs provided by the accounting departments.
The total costs of analyzed units amounted to 209 002 EUR (898 712 PLN), while the payment for palliative care services from the NHF amounted to 126 010 EUR (541 844 PLN), which accounted for only 60% of the costs incurred by the units. The average cost per person per day of hospitalization, calculated according to the actual duration of hospitalization in the unit, was 83 EUR (357 PLN), and the average payment from the NHF was 52.8 EUR (227 PLN). Underpayment per person per day was approximately 29.2 EUR (125 PLN).
The study showed a significant difference between the actual cost of palliative care units and the level of refund from the NHF. Based on the analysis of costs, the application has been submitted to the NHF to change the reimbursement amount of palliative care services in 2013.
姑息治疗病房的主要任务是通过适当的症状管理、医学专家与患者及其家属之间的沟通以及护理协调,为晚期进行性慢性病患者提供有尊严的生活。许多姑息治疗病房面临着来自国家卫生基金(NHF)的低收入问题,这导致了严重的经济问题。本研究的目的是估计选定姑息治疗病房的护理直接成本和管理成本以及每位患者每天的实际成本,并将结果与国家卫生基金的估值进行比较。
对175名患者的住院费用进行前瞻性研究,研究在五个姑息治疗病房(PCU)进行。与护理直接相关的成本在每个病房的特制表格上记录,同时还有会计部门提供的人员和管理成本。
分析病房的总成本为209002欧元(898712波兰兹罗提),而国家卫生基金支付的姑息治疗服务费用为126010欧元(5