Skip to main content
Top
Published in: Irish Journal of Medical Science (1971 -) 1/2015

01-03-2015 | Review Article

Patient level costing in Ireland: process, challenges and opportunities

Authors: A. Murphy, B. McElroy

Published in: Irish Journal of Medical Science (1971 -) | Issue 1/2015

Login to get access

Abstract

Background

In 2013, the Department of Health released their policy paper on hospital financing entitled Money Follows the Patient. A fundamental building block for the proposed financing model is patient level costing.

Aim

This paper outlines the patient level costing process, identifies the opportunities and considers the challenges associated with the process in the Irish hospital setting.

Methods

Methods involved a review of the existing literature which was complemented with an interview with health service staff.

Results

There are considerable challenges associated with implementing patient level costing including deficits in information and communication technologies and financial expertise as well as timeliness of coding. In addition, greater clinical input into the costing process is needed compared to traditional costing processes. However, there are long-term benefits associated with patient level costing; these include empowerment of clinical staff, improved transparency and price setting and greater fairness, especially in the treatment of outliers. These can help to achieve the Government’s Health Strategy.

Conclusions

The benefits of patient level costing need to be promoted and a commitment to investment in overcoming the challenges is required.
Literature
1.
go back to reference DoH (2012) Future health—a strategic framework for reform of the health service 2012–2015. Department of Health, Ireland DoH (2012) Future health—a strategic framework for reform of the health service 2012–2015. Department of Health, Ireland
2.
go back to reference DoH (2013) The establishment of hospital groups as a transition to independent hospital trusts. Department of Health, Ireland DoH (2013) The establishment of hospital groups as a transition to independent hospital trusts. Department of Health, Ireland
3.
go back to reference DoH (2013) Money follows the patient—policy paper on hospital financing. Department of Health, Ireland DoH (2013) Money follows the patient—policy paper on hospital financing. Department of Health, Ireland
4.
go back to reference DoH (2013) The path to universal healthcare—preliminary paper on universal health insurance. Department of Health, Ireland DoH (2013) The path to universal healthcare—preliminary paper on universal health insurance. Department of Health, Ireland
5.
go back to reference Walshe K, Smith J (2011) Healthcare management, 2 ed. Open University Press Walshe K, Smith J (2011) Healthcare management, 2 ed. Open University Press
6.
go back to reference Farrar S, Yi D, Sutton M, Chalkley M, Sussex J, Scott A (2009) Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis. Br Med J 339:b3047-1–b3047-8 Farrar S, Yi D, Sutton M, Chalkley M, Sussex J, Scott A (2009) Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis. Br Med J 339:b3047-1–b3047-8
7.
go back to reference O’Reilly J, Busse R, Häkkinen U, Or Z, Street A, Wiley M (2012) Paying for hospital care: the experience with implementing activity-based funding in five European countries. Health Econ Policy Law 7(1):73CrossRefPubMed O’Reilly J, Busse R, Häkkinen U, Or Z, Street A, Wiley M (2012) Paying for hospital care: the experience with implementing activity-based funding in five European countries. Health Econ Policy Law 7(1):73CrossRefPubMed
8.
go back to reference DoH (2013) Money follows the patient—policy paper on hospital financing frequently asked questions. Department of Health, Ireland DoH (2013) Money follows the patient—policy paper on hospital financing frequently asked questions. Department of Health, Ireland
9.
go back to reference NCP (2010) Technical aspects of the national Casemix programme—part II, N.C. Programme, Editor 2010. National Casemix Programme, Ireland NCP (2010) Technical aspects of the national Casemix programme—part II, N.C. Programme, Editor 2010. National Casemix Programme, Ireland
10.
go back to reference CNOH (2011) Annual report, C.N.O. Hospital, Editor 2011. Cappagh National Orthapaedic Hospital, Dublin CNOH (2011) Annual report, C.N.O. Hospital, Editor 2011. Cappagh National Orthapaedic Hospital, Dublin
11.
go back to reference Culliton G (2011) Roll-out of radical activity funding scheme planned, in Irish Medical Times 2011, Dublin Culliton G (2011) Roll-out of radical activity funding scheme planned, in Irish Medical Times 2011, Dublin
12.
go back to reference HSE (2012) Support services business plans 2012, H.S. Executive, Editor 2012. Health Services Executive, Ireland HSE (2012) Support services business plans 2012, H.S. Executive, Editor 2012. Health Services Executive, Ireland
13.
go back to reference Delaney M (2012) Case study: cardiothoracic surgery/cardiology in CUH. In workshop on patient level costing in health economic evaluation. Cork University Hospital Delaney M (2012) Case study: cardiothoracic surgery/cardiology in CUH. In workshop on patient level costing in health economic evaluation. Cork University Hospital
14.
go back to reference Fitzgerald B (2012) Patient level costing, St. James’ experience in workshop on patient level costing in health economic evaluation. Cork University Hospital Fitzgerald B (2012) Patient level costing, St. James’ experience in workshop on patient level costing in health economic evaluation. Cork University Hospital
15.
go back to reference CUH (2014) Patient level costing interview, 2014, Finance Department, Cork University Hospital CUH (2014) Patient level costing interview, 2014, Finance Department, Cork University Hospital
16.
go back to reference Mogyorosy Z, Smith P (2005) The main methodological issues in costing health care services: a literature review. Centre for Health Economics, University of York Working Papers, vol 7, pp 1–242 Mogyorosy Z, Smith P (2005) The main methodological issues in costing health care services: a literature review. Centre for Health Economics, University of York Working Papers, vol 7, pp 1–242
17.
go back to reference Zelman W, McCue M, Mikkikan A, Glick ND (2009) Financial management of health care organizations: an introduction to fundamental tools concepts, and applications. Blackwell, Oxford Zelman W, McCue M, Mikkikan A, Glick ND (2009) Financial management of health care organizations: an introduction to fundamental tools concepts, and applications. Blackwell, Oxford
19.
go back to reference Drummond M, Sculpher MJ, Torrance GW, O’Brien Bj, Stoddart GL (2007) Methods for the economic evaluation of health care programmes, 3rd ed edn. Oxford University Press, Oxford Drummond M, Sculpher MJ, Torrance GW, O’Brien Bj, Stoddart GL (2007) Methods for the economic evaluation of health care programmes, 3rd ed edn. Oxford University Press, Oxford
20.
go back to reference McElroy B, Murphy A (2014) An economic analysis of money follows the patient. Ir J Med Sci 183(1):15–22CrossRefPubMed McElroy B, Murphy A (2014) An economic analysis of money follows the patient. Ir J Med Sci 183(1):15–22CrossRefPubMed
21.
go back to reference Blunt I, Bardsley M (2012) Use of patient-level costing to increase efficiency in NHS trusts. Nuffield Trust, London Blunt I, Bardsley M (2012) Use of patient-level costing to increase efficiency in NHS trusts. Nuffield Trust, London
22.
go back to reference Phelps C (2000) Information diffusion and best practice adoption. In: Culyer AJ, Newhouse JP (eds) Handbook of health economics, North-Holland. Elsevier, The Netherlands Phelps C (2000) Information diffusion and best practice adoption. In: Culyer AJ, Newhouse JP (eds) Handbook of health economics, North-Holland. Elsevier, The Netherlands
23.
go back to reference Doyle G, Duffy L, McCahey M (2002) An empirical study of adoption/non-adoption of activity based costing in hospitals in Ireland, in Working Paper 2002. UCD Business School: Dublin Doyle G, Duffy L, McCahey M (2002) An empirical study of adoption/non-adoption of activity based costing in hospitals in Ireland, in Working Paper 2002. UCD Business School: Dublin
24.
go back to reference Doyle G, Eden R, Maingot M (2004) Case studies of ABC adoption in hospitals: a comparison across Canada and Ireland, in Working Paper 2004. UCD Business School: Dublin Doyle G, Eden R, Maingot M (2004) Case studies of ABC adoption in hospitals: a comparison across Canada and Ireland, in Working Paper 2004. UCD Business School: Dublin
25.
go back to reference Ridderstolpe L, Johansson A, Skau T, Rutberg H, Åhlfeldt H (2002) Clinical process analysis and activity-based costing at a heart center. J Med Syst 26(4):309–322CrossRefPubMed Ridderstolpe L, Johansson A, Skau T, Rutberg H, Åhlfeldt H (2002) Clinical process analysis and activity-based costing at a heart center. J Med Syst 26(4):309–322CrossRefPubMed
26.
go back to reference Lawson R (2005) The use of activity based costing in the healthcare industry: 1994 vs 2004. Res Healthc Fin Manag 10(1):77–94 Lawson R (2005) The use of activity based costing in the healthcare industry: 1994 vs 2004. Res Healthc Fin Manag 10(1):77–94
27.
go back to reference O’Callaghan A, Colgan M, McGuigan C, Smyth F, Haider N, O’Neill S, Moore D, Madhavan P (2012) A critical evaluation of HIPE data. Ir Med J 105(1):21–23 O’Callaghan A, Colgan M, McGuigan C, Smyth F, Haider N, O’Neill S, Moore D, Madhavan P (2012) A critical evaluation of HIPE data. Ir Med J 105(1):21–23
Metadata
Title
Patient level costing in Ireland: process, challenges and opportunities
Authors
A. Murphy
B. McElroy
Publication date
01-03-2015
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 1/2015
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-014-1114-3

Other articles of this Issue 1/2015

Irish Journal of Medical Science (1971 -) 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine