Abstract
Accreditation of hospitals and other institutions is a widely used instrument for the quality assurance in health care. However, relevant literature regarding the economic evaluation of hospital accreditation is still missing. To date no formal Cost-Benefit Analysis (CBA) or Cost-Utility Analysis (CUA) has been carried out. This study uses an existing framework specifically developed for the economic evaluation of hospital accreditation. Based on this framework, we identify and quantify the costs and selected benefits of the re-accreditation of a Swiss acute care hospital. Costs are identified and quantified by conducting key informant and expert interviews. Benefits are identified by hospital experts and rated using a newly developed validation tool. Costs of the re-accreditation amount to about CHF 870'000 (internal and external costs). Benefits in quality management (QM) and in the critical incident reporting system (CIRS) are quantified and rated by the hospital experts in the following order: (1) development or promotion of a quality or safety culture, (2) implementation of a hospital-wide complaint management, (3) fulfillment of the hospital vision, (4) improved image upon stakeholders (patients, suppliers etc.), (5) improved image in policy, (6) quality dashboard, (7) preparation of centralized quality documents, and (8) avoidance of liability cases. This study provides detailed information about costs and selected benefits associated with the re-accreditation of a Swiss acute care hospital. As opposed to the costs, benefits could not be monetized but were quantified using an expert rating to illustrate the impacts of the re-accreditation. Overall, our study confirms the difficulties in the economic evaluation of hospital accreditation, but it makes a step towards a formal CUA.
Highlights
Accreditation of hospitals and other institutions is a widely used instrument for the quality assurance in health care
Scope and objectives Based on the SIQNS framework by Mumford et al [4], the first aim of this study is to identify the costs and benefits associated with the re-accreditation of the KSGR
Identification and quantification of costs The costs were collected for the whole accreditation project
Summary
Accreditation of hospitals and other institutions is a widely used instrument for the quality assurance in health care. The number of accreditation programs and accredited hospitals has increased considerably over the last decades. Accountability and safety in health care has increasingly become an international concern [4]. In this regard, accreditation programs aim to improve the quality of care [5]. Whether accreditation contributes to a quality improvement is still controversial. Some argue that it does, in the sense of providing a useful tool to stimulate improvement in health service organizations [7] and in the processes of care and clinical outcomes [8]. Grepperud [2] argues that there is no convincing evidence for quality improvement
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