Authors

1Alberto Rando Caño, 2Juan Vega Barea, 3Carmen Moreno García, 4Petra Moreno Martín, 5Sonia Hermida Cerro, 5Natalia Mudarra García

Position

¹Enfermero. Supervisor de Hospital de Día Médico y Unidad del Dolor. Responsable de Desarrollo e Innovación del Área de Enfermería del Hospital Universitario Infanta Cristina, Parla (Madrid).²Enfermero. Supervisor de Urgencias Generales y Pediátricas. Responsable de Planes de Cuidados del Área de Enfermería del Hospital Universitario Infanta Cristina, Parla (Madrid).³Enfermera. Directora de Enfermería del Hospital Universitario Infanta Cristina, Parla (Madrid).⁴Enfermera. Supervisora de Área de Servicios Centrales. Responsable de Investigación del Área de Enfermería del Hospital Universitario Infanta Cristina, Parla (Madrid).⁵Enfermera de Hospital de Día Médico del Hospital Universitario Infanta Cristina, Parla (Madrid).

Contact address

Alberto Rando Caño. Hospital Universitario Infanta Cristina. Avda. 9 de junio, 2. 28981 Parla (Madrid).

Contact email: Alberto.rando@salud.madrid.org

Abstract

Objective: to identify indicators with which to be able to evaluate on a yearly­ basis the resources consumed in each procedure at the Medical Day-Hospital (MDH) as well as the cost thereof.
Methodology: descriptive retrospective study of costs associated with the performance of each procedure carried out at the MDH at the Hospital Universitario Infanta Cristina during the year 2010. In order to assign a value to each procedure carried out at the MDH, a relative weight was assigned to each procedure carried out at the unit, over the sum of the cost of nursing time employed in each procedure, the cost of fungible material of each procedure and the indirect expenses that might be charged to the MDH. The nursing time was weighted by means of the Nursing Production Units (NPU). The allocation of NPUs to each service was carried out by means of a nominal­ group of experts. An adequacy analysis of the services performed was carried out based on the number of associated procedures.
Results: the cost of services provided in the unit and the cost associated with each procedure included were quantified. The MDH had a portfolio of services that includes 64 procedures managed by 39 different services. The number of visits in this period was 11,395 sessions. A total of 10 services were classified as unsuitable, under which 211 sessions were managed. Three new features were introduced to the agendas of the unit, each intended for a procedure, and the assigned service was changed to 2 procedures.
Conclusions: the annual monitoring of the nursing product cost of the MDH is feasible based on the proposed indicators. It is also feasible to study its evolution and to perform subsequent efficacy and efficiency studies in order to optimize the unit´s resources.

Keywords:

evaluation; healthcare cost; management; medical day hospital; nursing costsnursing product

Versión en Español

Título:

Coste enfermero asociado a los procedimientos realizados en un hospital de día médico