Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study

Eichler, Klaus; Hess, Sascha; Chmiel, Corinne; Bögli, Karin; Sidler, Patrick; Senn, Oliver; Rosemann, Thomas; Brügger, Urs

doi:10.21256/zhaw-4885

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-4885

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study
Authors:	Eichler, Klaus Hess, Sascha Chmiel, Corinne Bögli, Karin Sidler, Patrick Senn, Oliver Rosemann, Thomas Brügger, Urs
DOI:	10.21256/zhaw-4885 10.1136/emermed-2013-202760
Published in:	Emergency Medicine Journal
Volume(Issue):	31
Issue:	10
Page(s):	818
Pages to:	823
Issue Date:	2014
Publisher / Ed. Institution:	BMJ Publishing Group
ISSN:	1472-0205 1472-0213
Language:	English
Subject (DDC):	362.11: Hospitals and related institutions
Abstract:	Background: Emergency departments (EDs) are increasingly overcrowded by walk-in patients. However, little is known about health-economic consequences resulting from long waiting times and inefficient use of specialised resources. We have evaluated a quality improvement project of a Swiss urban hospital: In 2009, a triage system and a hospital-associated primary care unit with General Practitioners (H-GP-unit) were implemented beside the conventional hospital ED. This resulted in improved medical service provision with reduced process times and more efficient diagnostic testing. We now report on health-economic effects. Methods: From the hospital perspective, we performed a cost comparison study analysing treatment costs in the old emergency model (ED, only) versus treatment costs in the new emergency model (triage plus ED plus H-GP-unit) from 2007 to 2011. Hospital cost accounting data were applied. All consecutive outpatient emergency contacts were included for 1 month in each follow-up year. Results The annual number of outpatient emergency contacts increased from n=10 440 (2007; baseline) to n=16 326 (2011; after intervention), reflecting a general trend. In 2007, mean treatment costs per outpatient were €358 (95% CI 342 to 375). Until 2011, costs increased in the ED (€423 (396 to 454)), but considerably decreased in the H-GP-unit (€235 (221 to 250)). Compared with 2007, the annual local budget spent for treatment of 16 326 patients in 2011 showed cost reductions of €417 600 (27 200 to 493 600) after adjustment for increasing patient numbers. Conclusions: From the health-economic point of view, our new service model shows ‘dominance’ over the old model: While quality of service provision improved (reduced waiting times; more efficient resource use in the H-GP-unit), treatment costs sustainably decreased against the secular trend of increase.
URI:	https://digitalcollection.zhaw.ch/handle/11475/12829
Fulltext version:	Published version
License (according to publishing contract):	CC BY-NC 3.0: Attribution - Non commercial 3.0 Unported
Departement:	School of Management and Law
Organisational Unit:	Winterthur Institute of Health Economics (WIG)
Appears in collections:	Publikationen School of Management and Law

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Eichler, K., Hess, S., Chmiel, C., Bögli, K., Sidler, P., Senn, O., Rosemann, T., & Brügger, U. (2014). Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study. Emergency Medicine Journal, 31(10), 818–823. https://doi.org/10.21256/zhaw-4885

Eichler, K. et al. (2014) ‘Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study’, Emergency Medicine Journal, 31(10), pp. 818–823. Available at: https://doi.org/10.21256/zhaw-4885.

K. Eichler et al., “Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study,” Emergency Medicine Journal, vol. 31, no. 10, pp. 818–823, 2014, doi: 10.21256/zhaw-4885.

EICHLER, Klaus, Sascha HESS, Corinne CHMIEL, Karin BÖGLI, Patrick SIDLER, Oliver SENN, Thomas ROSEMANN und Urs BRÜGGER, 2014. Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre : a cost comparison study. Emergency Medicine Journal. 2014. Bd. 31, Nr. 10, S. 818–823. DOI 10.21256/zhaw-4885

Eichler, Klaus, Sascha Hess, Corinne Chmiel, Karin Bögli, Patrick Sidler, Oliver Senn, Thomas Rosemann, and Urs Brügger. 2014. “Sustained Health-Economic Effects after Reorganisation of a Swiss Hospital Emergency Centre : A Cost Comparison Study.” Emergency Medicine Journal 31 (10): 818–23. https://doi.org/10.21256/zhaw-4885.

Eichler, Klaus, et al. “Sustained Health-Economic Effects after Reorganisation of a Swiss Hospital Emergency Centre : A Cost Comparison Study.” Emergency Medicine Journal, vol. 31, no. 10, 2014, pp. 818–23, https://doi.org/10.21256/zhaw-4885.