Hrifach Abdelbaste, Ganne Christell, Couray-Targe Sandrine, Brault Coralie, Guerre Pascale, Serrier Hassan, Rabier Hugo, Grguric Gwen, Farge Pierre, Colin Cyrille
1Pôle de Santé Publique, Service d'Evaluation Economique en Santé, Hospices Civils de Lyon, 162, Avenue Lacassagne - Bâtiment A, 69424 Lyon Cedex 03, France.
2HESPER EA 7425, Univ. Lyon, Université Claude Bernard Lyon 1, 69008 Lyon, France.
Cost Eff Resour Alloc. 2018 Oct 11;16:34. doi: 10.1186/s12962-018-0155-2. eCollection 2018.
The choice of cost data sources is crucial, because it influences the results of cost studies, decisions of hospital managers and ultimately national directives of policy makers. The main objective of this study was to compare a hospital cost accounting system in a French hospital group and the national cost study (ENC) considering the cost of organ recovery procedures. The secondary objective was to compare these approaches to the weighting method used in the ENC to assess organ recovery costs.
The resources consumed during the hospital stay and organ recovery procedure were identified and quantified retrospectively from hospital discharge abstracts and the national discharge abstract database. Identified items were valued using hospital cost accounting, followed by 2010-2011 ENC data, and then weighted using 2010-2011 ENC data. A Kruskal-Wallis test was used to determine whether at least two of the cost databases provided different results. Then, a Mann-Whitney test was used to compare the three cost databases.
The costs assessed using hospital cost accounting differed significantly from those obtained using the ENC data (Mann-Whitney; P-value < 0.001). In the ENC, the mean costs for hospital stays and organ recovery procedures were determined to be €4961 (SD €7295) and €862 (SD €887), respectively, versus €12,074 (SD €6956) and €4311 (SD €1738) for the hospital cost accounting assessment. The use of a weighted methodology reduced the differences observed between these two data sources.
Readers, hospital managers and decision makers must know the strengths and weaknesses of each database to interpret the results in an informed context.
成本数据来源的选择至关重要，因为它会影响成本研究的结果、医院管理者的决策，并最终影响政策制定者的国家指令。本研究的主要目的是比较一家法国医院集团的医院成本核算系统与考虑器官回收程序成本的国家成本研究（ENC）。次要目的是比较这些方法与 ENC 中用于评估器官回收成本的加权方法。
通过回顾医院出院摘要和国家出院摘要数据库，对住院期间和器官回收程序所消耗的资源进行识别和量化。使用医院成本核算对识别出的项目进行估值，然后使用 2010 - 2011 年 ENC 数据，并接着使用 2010 - 2011 年 ENC 数据进行加权。使用 Kruskal - Wallis 检验来确定至少两个成本数据库是否提供了不同的结果。然后，使用 Mann - Whitney 检验来比较这三个成本数据库。
使用医院成本核算评估的成本与使用 ENC 数据获得的成本有显著差异（Mann - Whitney；P 值 < 0.001）。在 ENC 中，住院和器官回收程序的平均成本分别确定为 4961 欧元（标准差 7295 欧元）和 862 欧元（标准差 887 欧元），而医院成本核算评估的相应成本为 12074 欧元（标准差 6956 欧元）和 4311 欧元（标准差 1738 欧元）。使用加权方法减少了这两个数据源之间观察到的差异。
读者、医院管理者和决策者必须了解每个数据库的优缺点，以便在知情的背景下解释结果。
