Claudia Hübner1, Walter Ried2, Steffen Flessa3. 1. Chair of Health Care Management, Faculty of Law and Economics, University of Greifswald, F.-Loeffler-Str. 70, Greifswald, Germany. claudia.huebner@uni-greifswald.de. 2. Chair of Public Finance, Faculty of Law and Economics, University of Greifswald, Greifswald, Germany. 3. Chair of Health Care Management, Faculty of Law and Economics, University of Greifswald, F.-Loeffler-Str. 70, Greifswald, Germany.
Abstract
OBJECTIVES: The concept of opportunity cost can be applied to the utilization of hospital beds with special focus on patients colonized or infected with multidrug-resistant organisms. Blocked beds due to isolation measures or increased length of stay may result in opportunity costs if newly arriving patients have to be rejected and the hospital is confronted with revenue foregone. However, the amount of these costs is unclear, since different approaches are used in the literature to determine the respective costs. Our paper develops a concept to assess opportunity costs from the perspective of a hospital. METHODS: The analysis is two-stage. In a first step, the probability of rejecting a patient due to over-occupancy in a hospital is calculated with a queuing model and a Monte Carlo simulation taking various assumptions into account. In a second step, the amount of the opportunity costs is calculated as an expected value applying a stochastic approach based on a potential patient pool. RESULTS: Opportunity costs will occur only with a probability that is influenced, among others, by current bed occupancy rates. They have to be measured by average net revenue foregone, i.e., by the difference between average revenue foregone and average costs avoided. CONCLUSIONS: Previous studies have a tendency of overestimating the occurrence or the size of opportunity costs with regard to the use of hospital beds. Nonetheless, its influence on the hospital budget is crucial and should be determined exactly.
OBJECTIVES: The concept of opportunity cost can be applied to the utilization of hospital beds with special focus on patients colonized or infected with multidrug-resistant organisms. Blocked beds due to isolation measures or increased length of stay may result in opportunity costs if newly arriving patients have to be rejected and the hospital is confronted with revenue foregone. However, the amount of these costs is unclear, since different approaches are used in the literature to determine the respective costs. Our paper develops a concept to assess opportunity costs from the perspective of a hospital. METHODS: The analysis is two-stage. In a first step, the probability of rejecting a patient due to over-occupancy in a hospital is calculated with a queuing model and a Monte Carlo simulation taking various assumptions into account. In a second step, the amount of the opportunity costs is calculated as an expected value applying a stochastic approach based on a potential patient pool. RESULTS: Opportunity costs will occur only with a probability that is influenced, among others, by current bed occupancy rates. They have to be measured by average net revenue foregone, i.e., by the difference between average revenue foregone and average costs avoided. CONCLUSIONS: Previous studies have a tendency of overestimating the occurrence or the size of opportunity costs with regard to the use of hospital beds. Nonetheless, its influence on the hospital budget is crucial and should be determined exactly.
Entities:
Keywords:
Decision-making; Hospital; Monte Carlo simulation; Multidrug-resistant organisms; Net revenue foregone; Opportunity costs
Authors: G Geldner; M Ruoff; H J Hoffmann; P Kiefer; M Georgieff; H Wiedeck Journal: Anasthesiol Intensivmed Notfallmed Schmerzther Date: 1999-07 Impact factor: 0.698
Authors: Sabine Engler-Hüsch; Thomas Heister; Nico T Mutters; Jan Wolff; Klaus Kaier Journal: BMC Health Serv Res Date: 2018-09-26 Impact factor: 2.655