Abstract
Background: Costs of inpatient days in hospitals are frequently the main drivers of total treatment costs, and their unit cost can markedly affect the outcomes of an economic evaluation. In many countries, the availability of unit cost data is limited and unit costs are often based on data from hospitals participating in clinical trials.
Objective: To provide data about unit costs of inpatient hospital days in The Netherlands from a healthcare provider’s perspective and to give an insight into the extent to which cost categories and total costs differ between hospitals.
Design: Unit costs were collected from 22 wards and 11 intensive care units (ICUs) of general and university hospitals involved in clinical trials with ‘piggy-backed’ economic evaluations. Direct costs, such as costs of nursing and medical materials, were calculated by dividing the annual cost per category of the nursing department by the annual number of inpatient days. Indirect costs, such as overheads and accommodation, were allocated to the nursing departments by applying direct allocation. All costs were expressed in 1998 euros (EUR).
Results: The mean costs per inpatient day were EUR230 (range: EUR154–EUR311) in general hospitals and EUR323 (range: EUR209–EUR400) in university hospitals. The mean costs per inpatient day in an ICU were EUR1125 (EUR919–EUR1560). Between 38–48% of the total costs were made up of nursing costs. All cost categories showed wide variations between hospitals.
Conclusions: The results of this study were used to develop standard costs for inpatient days in The Netherlands and may contribute to the comparability and generalisability of economic evaluations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Drummond MF, O’Brien B, Stoddart GL, et al. Methods for the economic evaluation of health care programmes. 2nd ed. New York: Oxford University Press, 1997
Gold MR, Siegel JE, Russell LB, et al. Cost-effectiveness in health and medicine. 1st ed. New York: Oxford University Press, 1996
Goeree R, Gafni A, Hannah M, et al. Hospital selection for unit cost estimates in multicentre economic evaluations; does the choice of hospitals make a difference. Pharmacoeconomics 1999; 15 (6): 561–72
Raikou M, Briggs A, Gray A, et al. Centre-specific or average unit costs in multi-centre studies?: some theory and simulation. Health Econ 2000; 9: 191–8
Hakkaart-van Roijen L. Societal perspective on the cost of illness [PhD thesis]. Rotterdam: Erasmus Medical Center, 1998
Polder JJ. Cost of illness in the Netherlands [PhD thesis]. Rotterdam: Erasmus Medical Center, 2001
Sullivan SD, Ramsey SD, Lee TA. The economic burden of COPD. Chest 2000; 117: 5S–9S
van Agthoven M, Vellenga E, Fibbe WE, et al. Cost analysis and quality of life assessment comparing patients undergoing autologous peripheral blood stem cell transplantation or autologous bone marrow transplantation for refractory or relapsed non-Hodgkin’s lymphoma or Hodgkin’s disease: a prospective randomised trial. Eur J Cancer 2001; 37 (14): 1781–9
Oostenbrink JB, Koopmanschap MA, Rutten FFH. Manual for costing: methods and standard costs for economic evaluations in healthcare [in Dutch]. Amstelveen: College voor zorgverzekeringen, 2000
Oostenbrink JB, Koopmanschap MA, Rutten FFH. Standardisation of costs; the Dutch manual for costing in economic evaluations. PharmacoEconomics 2002; 20 (7): 443–54
Riteco JA, Heij LJM de, Luijn JCF van, et al. Dutch guidelines for pharmacoeconomic research. Amstelveen: Health Insurance Council, 1999 Mar
Dutch Hospital Institute. NZI rekeningenschema voor Gezondheidszorginstellingen en verzorgingshuizen. (NZI cost accounting scheme for intramural organisations in healthcare). Utrecht: Dutch Hospital Institute, 1994
Horngren CT. Cost accounting. 5th ed. Englewood Cliffs: Prentice-Hall, 1982
Davidoff AJ, Powe NR. The role of perspective in defining economic measures for the evaluation of medical technology. Int J Technol Assess 1996; 12-1: 9–21
Commonwealth Department of Health and Ageing. Manual of resource items and their associated costs. Canberra 2002. Available from URL: http://www.health.gov.au/pbs/pubs/manual [Accessed 2003 Jan 28]
Jacobs P, Roos NP. Standard cost lists for healthcare in Canada. Pharmacoeconomics 1999; 15 (6): 551–60
Institute of Health Economics. A national list of provincial costs for health care 1997/8. Edmonton: Institute of Health Economics, 2000
Ferguson B. NHS database of reference costs is severely flawed. BMJ 2001; 323: 106
Acknowledgements
No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Oostenbrink, J.B., Buijs-Van der Woude, T., van Agthoven, M. et al. Unit Costs of Inpatient Hospital Days. Pharmacoeconomics 21, 263–271 (2003). https://doi.org/10.2165/00019053-200321040-00004
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-200321040-00004