Abstract
BackgroundIn 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of this study is to describe the relationship between timing of radiological interventions, in particular scan and treatment day, and the length of stay (LOS) compliance in a hospital.MethodsThis is a cross-sectional observational study based on administrative records of all DRG cases in a Swiss university hospital in 2013, enriched by data from the radiology information system and accounting details. The data are analysed using descriptive statistics and regression methods.ResultsRadiology and related treatment on a weekend is associated with a higher LOS compliance of approximately 22.12% (p<0.01) compared to scans and treatments on weekdays, controlling for gender, age and insurance of the patient, as well as detailed medical and radiology-related factors. The higher LOS compliance is driven by emergency cases, which supports the hypothesis that for those cases on weekends more efficient scan and treatment processes are in place.ConclusionThe study provides evidence on how days of radiological intervention are related to LOS compliance in a Swiss hospital under DRG and attempts to explain how this is linked to standardised operating procedures. Our results have implications regarding potential cost savings in hospital care through alignment of care processes, infrastructure planning and guidance of patient flows.
Highlights
In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs
While none of our indicators for weekend scan, weekend treatment or the interaction term is significantly related to length of stay (LOS) compliance in the sample of non-emergency cases, we find a significant association of Working day Weekend treatment treatment
This study describes the relationship between scan and treatment day and LOS compliance in a Swiss university hospital
Summary
In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. Current discussion Current research in hospital financing aims at both cost controlling and quality improvement [1, 2]. Clinical processes, including radiology, may be structured more efficiently to increase hospital performance and quality of services provision. This paper aims at describing the relationship between radiological intervention days and LOS compliance in Napierala and Boes BMC Health Services Research (2017) 17:168 a Swiss university hospital. The underlying hypothesis is that radiological interventions (i.e., scans and related treatments) on weekends as opposed to weekdays have a positive influence on hospital performance in both resource use and quality of care by affecting compliance of LOS. We use LOS compliance as an indicator of hospital performance, process management and quality of care. We aim at avoiding the shortcomings of the often used LOS dimension which in our view does not adequately deal with process efficiency and quality improvements as there is no reference or output dimension attached
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
